DR. MICHAEL LEE CLARK (NPI# 1457662280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457662280 |
Entity Type | Individual |
Full Name | DR. MICHAEL LEE CLARK |
Credential | D.O. |
Practice Address |
3430 Tamiami Trl Ste B Port Charlotte FL 33952-8148 |
Mailing Address |
2000 Ogden Ave Aurora IL 60504-7222 |
Practice Telephone | 8556744624 |
Mailing Telephone | 6308984515 |
Mailing Fax Number | 6309786805 |
Enumeration Date | 2010-06-26 |
Last Update Date | 2019-09-30 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036132955 | IL | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
1942715255 | Michael Clark | Physical Medicine & Rehabilitation | 10600 Riverside Drive, Coral Springs, FL 33071-3307 | 2017-12-08 |
1386170348 | Michael Clark | Registered Nurse | 317 E 100 N, Price, UT 84501-2504 | 2017-05-11 |
1184163982 | Michael Clark | Specialist/Technologist | 19 Second Ave, Auburn, NY 13021-5113 | 2017-02-14 |
1356780837 | Michael Clark | Adult Companion | 8305 Concord Dr, Rowlett, TX 75089-2001 | 2013-06-18 |
1417394503 | Michael Ray Clark | Pharmacist | 2661 Valleydale Rd, Hoover, AL 35244-2026 | 2013-05-29 |
1407143381 | Michael Jeffery Clark | Orthopaedic Surgery | 5671 Peachtree Dunwoody Ste 700, Atlanta, GA 30342-5047 | 2011-06-29 |
1700183993 | Michael Brady Clark | Preventive Medicine | 1400 Mckean Rd, Spring House, PA 19477 | 2011-02-24 |
Street Address |
3430 TAMIAMI TRL STE B |
City | PORT CHARLOTTE |
State | FL |
Zip Code | 33952-8148 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700486552 | Arrow Medical LLC | Durable Medical Equipment & Medical Supplies | 3514 Tamiami Trail, Unit 104, Port Charlotte, FL 33952 | 2020-10-30 |
1376009621 | David Alan Mowry | Massage Therapist | 3148 Whiting Lane, Port Charlotte, FL 33952 | 2019-02-12 |
1124527189 | Aegis Group Practice, LLC | Physical Therapist | 2500 Aaron Street, Port Charlotte, FL 33952 | 2018-02-06 |
1255856118 | All Powered Mobility, LLC | Durable Medical Equipment & Medical Supplies | 2765 Tamiami Trl Ste B1, Port Charlotte, FL 33952 | 2017-08-11 |
1366994915 | Julianne Kumar | Physical Medicine & Rehabilitation | 4166 Tamiami Trail, Unit A, Port Charlotte, FL 33952 | 2016-10-31 |
1659729549 | The Gathering Place LLC | Licensed Practical Nurse | 3459 Depew Ave, Port Charlotte, FL 33952 | 2016-06-01 |
1003222183 | Philip Lagamma | Physical Therapist | 4161 Tamiami Trl Ste 103, Port Charlotte, FL 33952 | 2014-07-09 |
1184039695 | Nathan E Shipley | Driver | 2338 Alton Rd., Port Charlotte, FL 33952 | 2014-06-23 |
1619318219 | Nic 4 Royal Palm Leasing LLC | Assisted Living Facility | 2500 Aaron St., Port Charlotte, FL 33952 | 2013-07-11 |
1225306475 | Tamjo Inc | Hearing Instrument Specialist | 2811 Ste. A Tamiami Trail, Port Charlotte, FL 33952 | 2011-12-02 |
Find all providers in zip 33952 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225361850 | Advanced Imaging of Port Charlotte | Radiology | 2625 Tamiami Trail, Unit 1, Port Charlotte, FL 33952 | 2009-09-15 |
1619994456 | Michael C Heagney | Radiology | 4550 Grassy Point Blvd, Port Charlotte, FL 33952-9179 | 2006-07-17 |
1851331623 | Molecular Imaging of Charlotte County, LLC | Radiology | 4130 Tamiami Trl, Suite 101, Port Charlotte, FL 33952-9207 | 2006-06-08 |
1114973542 | Margo H Roca | Radiology | 18451 Meyer Ave, Port Charlotte, FL 33948-8931 | 2006-05-26 |
1720068497 | Fawcett Medical Imaging Pa | Radiology | 21298 Olean Blvd, Port Charlotte, FL 33952-6705 | 2006-01-19 |
1548248503 | Stanley J Litvak | Radiology | 3430c Tamiami Trl, Port Charlotte, FL 33952-8127 | 2006-01-09 |
1831175561 | James Edward White | Radiology | 3430 Tamiami Trl, Suite B, Port Charlotte, FL 33952-8127 | 2005-12-15 |
1568453892 | Seaside Radiology Consultants Pa | Radiology | 3430 Tamiami Trail, Unit B, Port Charlotte, FL 33952 | 2005-11-04 |
1659365021 | Advanced Imaging of Port Charlotte LLC | Radiology | 2625 Tamiami Trl, Unit 1, Port Charlotte, FL 33952-6478 | 2005-08-31 |
1164888954 | American Imaging of Southwest Florida,inc | Radiology | 23081 Harborview Rd, Port Charlotte, FL 33980-2153 | 2016-01-08 |
Find all providers in PORT CHARLOTTE |
City | PORT CHARLOTTE |
Zip Code | 33952 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.