GREGORY CLARK (NPI# 1760991012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760991012 |
Entity Type | Individual |
Full Name | GREGORY CLARK |
Practice Address |
1091 Old South Dr Lakeland FL 33811 |
Mailing Address |
1091 Old South Dr Lakeland FL 33811-2333 |
Practice Telephone | (813) 846-1181 |
Mailing Telephone | 8138461181 |
Enumeration Date | 2017-09-28 |
Last Update Date | 2017-09-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 172A00000X | Driver | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184758229 | Gregory Ray Clark | Physical Therapist | 3 Windsor Ct, Shawnee, OK 74804-2330 | 2007-03-14 |
1114064797 | Gregory Dale Clark | Dentist | 4212 Mcever Rd, Oakwood, GA 30566-2237 | 2007-01-31 |
1225141823 | Gregory Lynn Clark | Specialist | 11790 Sw Barnes Rd, Suite 330, Portland, OR 97225-5934 | 2006-08-16 |
1689608952 | Gregory D Clark | Social Worker | 118 Broadway N, Ste 810, Fargo, ND 58102-4949 | 2006-07-10 |
1164409728 | Gregory Clark | Counselor | 225 N Beaumont Rd, Prairie Du Chien, WI 53821-1445 | 2005-12-26 |
1528627833 | Gregory Scott Clark | Nurse Anesthetist, Certified Registered | 3333 W Deyoung St, Marion, IL 62959-5884 | 2019-06-10 |
1073178851 | Gregory Clark | Student in an Organized Health Care Education/Training Program | 550 1st Ave, New York, NY 10016-6402 | 2019-05-07 |
1548736622 | Gregory Allen Clark | Marriage & Family Therapist | 1150 5th St Ste 270, Coralville, IA 52241-2933 | 2018-10-16 |
1881055911 | Gregory Scott Clark Jr. | Counselor | 1121 E Southeast Loop 323 Ste 204, Tyler, TX 75701 | 2016-03-17 |
1164841102 | Gregory S Clark | Physician Assistant | 8433 Harcourt Rd Ste 100, Indianapolis, IN 46260-2193 | 2014-04-07 |
Street Address |
1091 OLD SOUTH DR |
City | LAKELAND |
State | FL |
Zip Code | 33811 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952910200 | Darielle Shanette Berrian | Assisted Living Facility | 1548 Georgetown Dr, Lakeland, FL 33811 | 2020-07-23 |
1356870703 | Jeanette Michelle Edmonds | Psychologist | 4231 S. Pipkin Rd., Building 2 - Mental Health/behavioral Sciences, Lakeland, FL 33811 | 2017-06-08 |
1932353406 | Monique L Lisowski | Dietitian, Registered | 4231 South Pipkin Road, Lakeland, FL 33811 | 2008-11-11 |
1306987029 | Lifesavers Home Respiratory, Inc. | Durable Medical Equipment & Medical Supplies | 2525 Drane Field Rd, Suite 14, Lakeland, FL 33811 | 2007-02-08 |
1518010305 | Kirk Randall Smith | Nurse Practitioner | 1475 Airport Road, Lakeland, FL 33811 | 2007-01-18 |
1578568176 | Southeastern Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 3615 Century Blvd, Unit #1, Lakeland, FL 33811 | 2005-06-20 |
1225279318 | Affordable Transport Inc. | Non-emergency Medical Transport (VAN) | 3706 Dmg Dr, Lakeland, FL 33811-1043 | 2009-03-18 |
1457747875 | Candace Borders | Physical Therapy Assistant | 3225 Thoroughbred Loop N, Lakeland, FL 33811-1078 | 2015-04-13 |
1962849729 | Angelica Monteverde | Counselor | 3121 Filly Ln, Lakeland, FL 33811-1080 | 2013-06-03 |
1821440686 | Claudia White Borders | Counselor | 3058 Sire Trl, Lakeland, FL 33811-1090 | 2016-07-05 |
Find all providers in zip 33811 |
Taxonomy Code | 172A00000X |
Grouping | Other Service Providers |
Classification | Driver |
A person employed to operate a motor vehicle as a carrier of persons or property. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720632896 | Monica Smith | Driver | 714 S Ingraham Ave, Lakeland, FL 33801-5602 | 2019-07-27 |
1366917650 | Dennis Small | Driver | 9160 Highway 64 Ste 12-187, Lakeland, TN 38002-4766 | 2018-10-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083212872 | Webster Luccin | Driver | 4175 S Congress Ave Ste B, Palm Springs, FL 33461-4725 | 2020-10-13 |
1225636434 | Toccara S Bennett | Driver | 5721 Rywood Dr, Orlando, FL 32810-6610 | 2020-10-12 |
1235736398 | Meekins Senior Shuttle | Driver | 15599 Moss Hollow Dr, Jacksonville, FL 32218-6875 | 2020-10-01 |
1063026037 | Jarilsa E Narvaez | Driver | 3975 Sunset Rd, Lehigh Acres, FL 33971-5638 | 2020-09-07 |
1164035887 | Lovell Braswell Jr. | Driver | 3706 Nw 122nd Ter, Sunrise, FL 33323-3319 | 2020-08-24 |
1093327009 | Toni Mabien | Driver | 4701 E Hanna Ave, Tampa, FL 33610-2522 | 2020-08-20 |
1770193203 | Timothy Webster Sr. | Driver | 1465 Shadow Creek Dr, Orange Park, FL 32065-2514 | 2020-08-10 |
1780293068 | Guillermo Gonzalez I | Driver | 1037 Ne Pine Island Ln, Cape Coral, FL 33909-2176 | 2020-07-23 |
1821606633 | Miguel Angel Cedeno | Driver | 6513 14th St W Ste 141, Bradenton, FL 34207-5803 | 2020-07-17 |
1912525379 | Rafael Martinez | Driver | 10967 Peppertree Ln, Port Richey, FL 34668-2420 | 2020-07-10 |
Find all providers with the same taxonomy |
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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.