Individual
ASHLEY MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7381 COLLEGE PKWY STE 110, FORT MYERS, FL 33907-5527
(239) 482-1010
(239) 481-1481
Mailing address
12730 NEW BRITTANY BLVD STE 602, FORT MYERS, FL 33907-4690
(239) 275-5522
(239) 275-4464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME137469
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100022600
—
FL
01
—
Z5S0K
FLORIDA BLUE
FL
Enumeration date
05/31/2015
Last updated
03/19/2020
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