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Individual

JANET E CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3249 SUNSET KEY CIR, PUNTA GORDA, FL 33955-1969
(941) 575-9372
Mailing address
3249 SUNSET KEY CIR, PUNTA GORDA, FL 33955-1969
(941) 575-9372

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME0067790
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050079777
MCRR
FL
01
0867335
CIGNA
FL
01
2488479
AETNA
FL
05
260754900
FL
01
51855
BSFL
FL
01
51855Z
MCR
FL
Enumeration date
10/21/2005
Last updated
06/15/2012
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