Individual
MRS. STEPHANIE ANN CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD, LD/N
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
Mailing address
6010 TOWER RD, LAND O LAKES, FL 34638-3134
(813) 972-2000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND3876
FL
Other
Enumeration date
06/09/2006
Last updated
07/08/2007
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