Organization
TOTAL LIFE CARE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSHUNYA SHAVON CLARK ARNP (CEO)
(352) 870-5025
Entity
Organization
Contact information
Practice address
55 S PALM AVE, SARASOTA, FL 34236-5610
(941) 777-5661
Mailing address
PO BOX 3941, SARASOTA, FL 34230-3941
(941) 777-5661
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9214368
FL
Other
Enumeration date
05/24/2017
Last updated
03/01/2018
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