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NPI Code Detail

MEDICARE: PATRICIA CLARKE ARNP

MEDICARE: PATRICIA CLARKE ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerARNP 1739772FL

General Provider Information

NPI Number : 1013906544
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA CLARKE ARNP
Provider Business Mailing Address
First Line : 2400 NE 209TH TER
Second Line :
City : MIAMI
State : FL
Zip : 33180-1042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 801 S DOUGLAS RD
Second Line : CHILDREN'S MOBILE HEALTH CENTER
City : PEMBROKE PINES
State : FL
Zip : 33025-1355
Country : US
Telephone Number : 954-985-1220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 07/08/2007

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