MEDICARE: MICHELINE CLERCY

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	363LF0000X	Family Nurse Practitioner	11029197	FL

General Provider Information

NPI Number	:	1356193379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELINE CLERCY

Provider Business Mailing Address
First Line	:	1221 SW 6TH WAY
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-6366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3275 W HILLSBORO BLVD STE 206
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-9476
Country	:	US
Telephone Number	:	561-794-3014
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	04/03/2024

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Directions to “ MICHELINE CLERCY ” Practice Location

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