MEDICARE: CLARKE MEDICAL SERVICES INC

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
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1053353789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARKE MEDICAL SERVICES INC

Provider Business Mailing Address
First Line	:	6555 NW 36TH ST
Second Line	:	112
City	:	VIRGINIA GARDENS
State	:	FL
Zip	:	33166-6978
Country	:	US
Telephone Number	:	305-219-8593
Fax Number	:

Provider Business Practice Location Address
First Line	:	6555 NW 36TH ST
Second Line	:	112
City	:	VIRGINIA GARDENS
State	:	FL
Zip	:	33166-6978
Country	:	US
Telephone Number	:	305-219-8593
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUZ SABOGAL
Credential	:
Telephone Number	:	305-219-8593

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	08/22/2020

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Directions to “CLARKE MEDICAL SERVICES INC ” Practice Location

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