Individual
RANDY W CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14911 SE 73RD AVE, SUMMERFIELD, FL 34491-4225
(352) 789-2908
Mailing address
14911 SE 73RD AVE, SUMMERFIELD, FL 34491-4225
(352) 789-2908
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAP.0100612
FL
Other
Enumeration date
01/05/2026
Last updated
02/23/2026
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