MICHAEL J CLARK

CLERMONT, FL
NPI1063511921
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PA0002555)
Enumeration Date2006-09-21
Last Update Date2007-07-08
Business Address
-- MICHAEL J CLARK PA
1099 CITRUS TOWER BLVD
CLERMONT, FL 34711-1947
Phone number: 352-394-4071
Mailing Address
-- MICHAEL J CLARK PA
PO BOX 628296
ORLANDO, FL 32862-8296
Phone number: 407-741-9418
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