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General NPI Number Information
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NPI Number | 1245450006
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Entity Type | Organization
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Legal Business Name | CLARKSON & COLLINS DO PA
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/21/2011
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Provider Practice Location Address
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Address Line | 13020 PARK BLVD
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City | SEMINOLE
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State | FL
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Zip | 33776-3639
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Country | US
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Telephone | 727-393-3404
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Fax | 727-394-1804
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Provider Business Mailing Address
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Address Line | 13020 PARK BLVD
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City | SEMINOLE
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State | FL
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Zip | 33776-3639
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Country | US
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Telephone | 727-393-3404
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Fax | 727-393-4814
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. MARIANNE FISHER
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Credential |
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Telephone | 727-393-3404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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