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General NPI Number Information
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NPI Number | 1538521307
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Entity Type | Individual
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Provider Name | JOHN EDWARD CLORE
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Gender | Male
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 2572 W STATE ROAD 426 STE 1048
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City | OVIEDO
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State | FL
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Zip | 32765-8389
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Country | US
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Telephone | 407-365-4459
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Fax | 407-365-4144
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Provider Business Mailing Address
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Address Line | 10140 CENTURION PKWY N
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City | JACKSONVILLE
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State | FL
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Zip | 32256-0532
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Country | US
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Telephone | 904-697-4127
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Fax | 904-697-5102
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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 | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | ME140404
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME140404
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License Number State | FL
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