Individual
DR. CHERYL A. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-7283
(407) 303-0347
Mailing address
601 E ROLLINS ST, ORLANDO, FL 32803-1248
(407) 303-7283
(407) 303-0347
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
39002779A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME45484
FL
207RP1001X
Pulmonary Disease Physician
ME45484
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01035
BLUE CROSS BLUE SHIELD
FL
05
—
019628100
—
FL
Enumeration date
05/25/2006
Last updated
10/15/2022
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