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Individual

MATTHEW CLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
1201 NW 16TH ST, MIAMI, FL 33125-1624
(305) 575-7000
Mailing address
601 THREE ISLANDS BLVD APT 307, HALLANDALE BEACH, FL 33009-2831
(954) 470-7054

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5217225
FL

Other

Enumeration date
11/26/2014
Last updated
11/26/2014
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