Individual
DR. ALAN STARK CLELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14540 OLD SAINT AUGUSTINE RD STE 2317, CREDENTIALING DEPARTMENT, JACKSONVILLE, FL 32258-7418
(904) 880-9696
(904) 390-7452
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME90885
FL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME90885
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2773198 00
—
FL
01
—
P00669211
RAILROAD MEDICARE
FL
Enumeration date
11/21/2005
Last updated
11/19/2024
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