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1790246270
JONATHAN ANDREW CLARK
ST PETERSBURG, FL
NPI
1790246270
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL 11000850)
Enumeration Date
2019-03-27
Last Update Date
2019-03-27
Business Address
JONATHAN ANDREW CLARK APRN
5042 12TH AVE N
ST PETERSBURG, FL 33710-6011
Phone number: 727-631-2091
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Mailing Address
JONATHAN ANDREW CLARK APRN
5042 12TH AVE N
ST PETERSBURG, FL 33710-6011
Phone number: 727-631-2091
Copy
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