Individual
CARILLA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 CLARCONA RD, APOPKA, FL 32703-8762
(863) 254-8786
Mailing address
3000 CLARCONA RD, APOPKA, FL 32703-8762
(863) 254-8786
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
0100603.A
FL
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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