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Dr. Desra Kay Clark, DO
Adult Medicine Physician in Cocoa, Florida
NPI 1477816601

Desra Kay Clark is an Adult Medicine Physician based in Melbourne, FL and is specialized in Adult Medicine. Desra Kay Clark practices in Cocoa, FL and has the professional credentials of DO. The NPI Number for Desra Kay Clark is 1477816601 and holds a License No. OS12364 (Florida).

The current practice location address for Desra Kay Clark is 7227 N Us Highway 1, Cocoa, FL and can be reached out via phone at 321-877-2740 and via fax at 321-877-2793.

Location: 7227 N Us Highway 1, Cocoa, FL, 32902-1137
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477816601
Provider Name
Desra Kay Clark
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
7227 N Us Highway 1, Cocoa, FL, 32902-1137
Phone Number
321-877-2740
Fax Number
321-877-2793
Provider Enumeration Date
06/22/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
019789000 05 FL
institution
Provider Business Practice Location Address Details
Address
7227 N Us Highway 1
City
Cocoa
State
Florida
Zip
32927-5020
Phone Number
321-877-2740
Fax Number
321-877-2793
person
Provider Business Mailing Address Details
Address
7227 N Us Highway 1
City
Cocoa
State
Florida
Zip
32927-5020
Phone Number
321-877-2740
Fax Number
321-877-2793
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
OS12364 (Florida)
Definition
Definition to come.
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