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General NPI Number Information
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NPI Number | 1215069794
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Entity Type | Individual
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Provider Name | SHERI LYNN CLARY PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17595 S TAMIAMI TRL SUITE #108
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City | FORT MYERS
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State | FL
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Zip | 33908-4570
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Country | US
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Telephone | 239-267-4788
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Fax |
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Provider Business Mailing Address
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Address Line | 9007 WHITFIELD DR
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City | ESTERO
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State | FL
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Zip | 33928-4409
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Country | US
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Telephone | 239-992-1026
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Fax | 239-992-7608
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA3097
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License Number State | FL
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