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General NPI Number Information
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NPI Number | 1437342847
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Entity Type | Individual
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Provider Name | GRACE ANGELA LEVY-CLARKE MD
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Gender | Female
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 11809 N DALE MABRY HWY
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City | TAMPA
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State | FL
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Zip | 33618-3505
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Country | US
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Telephone | 727-317-5830
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Fax | 888-412-1795
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Provider Business Mailing Address
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Address Line | 1703 N MCMULLEN BOOTH RD UNIT 764
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-9630
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Country | US
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Telephone | 727-317-5830
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Fax | 888-539-6488
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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 | 207WX0108X
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Taxonomy Name | Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
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License Number | ME99689
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License Number State | FL
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