Individual
GARY MARC MCCLERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
14741 WATERWAY DR, HUDSON, FL 34667
(727) 432-1919
Mailing address
14741 WATERWAY DR, HUDSON, FL 34667-3258
(727) 432-1919
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO2389
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019585300
—
FL
01
—
65368Z
INDIVIDUAL MCARE PTAN
FL
01
—
DS9118
RR MCARE IND PTAN
AL
01
—
DS9118
GROUP RR
FL
01
—
FS503A
GROUP MCARE PTAN
FL
01
—
PO2389
STATE LICENSE
FL
Enumeration date
02/02/2006
Last updated
06/16/2018
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