Search › Florida › 251B00000X
Jason Clark
NPI 1568711513 · on the registry since 2012 · sole proprietor
Practice
- Address
- 4615 Philips Highway
Jacksonville, FL 32207 - Phone
- (904) 739-7006
- Fax
- (904) 737-3412
- Organisation at this address
- Lutheran Social Services Of Ne Fl Inc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 251B00000X
251B00000X
- Licence states on file
- FL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-09-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida