Individual
ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2100 VIA BELLA BLVD, STE. 204, LAND O LAKES, FL 34639-5429
(813) 751-3636
(813) 377-1678
Mailing address
38135 MARKET SQUARE, ZEPHRHILLS, FL 33542
(813) 780-1255
(813) 780-9773
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1600042
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300899100
—
FL
01
—
500014246
RR MEDICARE
FL
Enumeration date
07/26/2006
Last updated
10/02/2015
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