Individual
DR. STEPHANIE DONOSO CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1414 E MAIN ST STE 2, LEESBURG, FL 34748-5399
(352) 775-2055
(352) 901-6954
Mailing address
1414 E MAIN ST STE 2, LEESBURG, FL 34748-5399
(352) 775-2055
(352) 901-6954
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
70577
AZ
207Q00000X
Family Medicine Physician
ME165643
FL
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
ME165643
FL
Other
Enumeration date
05/11/2020
Last updated
02/24/2026
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