Individual
DR. LESLEY CLARK-LOESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3501 S UNIVERSITY DR, SUITE 5, DAVIE, FL 33328-2001
(954) 998-0345
(954) 998-0344
Mailing address
3501 S UNIVERSITY DR, SUITE 5, DAVIE, FL 33328-2001
(954) 998-0345
(954) 998-0344
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME92842
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28636
BC & BS OF FLORIDA
FL
Enumeration date
10/03/2005
Last updated
01/17/2017
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