Alec Cole Clark, is a
Behavior Technician physician based in Dade City, Florida. Alec Cole Clark is licensed to practice in * (Not Available) (license number ) and his current practice location is 15048 14th St, Dade City, Florida. He can be reached at his office (for appointments etc.) via phone at
(352) 232-8997.
NPI number for Alec Cole Clark is 1003511072 and his current mailing address is 15048 14th St, Dade City, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1003511072.
Physician's Profile
| Full Name | Alec Cole Clark |
|---|
| Gender | Male |
|---|
| Speciality | Behavior Technician |
|---|
| Location | 15048 14th St, Dade City, Florida |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1003511072
- Provider Enumeration Date: 03/31/2023
- Last Update Date: 09/17/2025
Medical Identifiers
Medical identifiers for Alec Cole Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003511072 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207T00000X | Neurological Surgery | T-5055 (Mississippi) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alec Cole Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Alec Cole Clark,
15048 14th St,
Dade City, FL 33523-2503
Ph: (352) 232-8997 | Alec Cole Clark,
15048 14th St,
Dade City, FL 33523-2503
Ph: (352) 232-8997 |
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