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General NPI Number Information
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NPI Number | 1053402974
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Entity Type | Individual
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Provider Name | PAUL R CLEMENTS PHD, ARNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 2605 GULF BLVD
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City | BELLEAIR BEACH
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State | FL
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Zip | 33786-3500
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Country | US
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Telephone | 727-641-5507
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Fax | 866-533-1384
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Provider Business Mailing Address
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Address Line | 2605 GULF BLVD
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City | BELLEAIR BEACH
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State | FL
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Zip | 33786-3500
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Country | US
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Telephone | 727-641-5507
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Fax | 866-533-1384
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 9231546
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License Number State | FL
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