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Individual

MRS. JUDITH YVETTE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
7242 W COLONIAL DR, ORLANDO, FL 32818-6749
(407) 296-2273
(407) 294-9740
Mailing address
7242 W COLONIAL DR, ORLANDO, FL 32818-6749
(407) 296-2273
(407) 294-9740

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN1442252
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014122300
FL
01
Y086K
BCBS
FL
Enumeration date
04/21/2011
Last updated
08/13/2021
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