Individual
DR. MICHAEL JONATHAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 NOKOMIS AVE S, VENICE, FL 34285-2617
(941) 355-2767
(941) 355-0617
Mailing address
2401 UNIVERSITY PKWY STE 102, SARASOTA, FL 34243-2894
(941) 355-2767
(941) 355-0617
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MT186642
PA
Other
Enumeration date
05/22/2008
Last updated
10/28/2021
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