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Individual

DR. SONYA MICIAK CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
600 PALMETTO ST, NEW SMYRNA BEACH, FL 32168-7327
(386) 424-6845
(386) 424-3847
Mailing address
770 W GRANADA BLVD STE 101, ORMOND BEACH, FL 32174-5179
(386) 231-4519
(386) 368-8927

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
32951
SC
207XS0106X
Orthopaedic Hand Surgery Physician
2016-02120
NC
207XS0106X
Orthopaedic Hand Surgery Physician
32951
SC
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
OS22614
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04301531
MS
05
1519420
TN
Enumeration date
03/22/2007
Last updated
11/18/2025
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