Clark, Candace
Clark, Candace is an sole proprietor health care provider with primary practice located at 17008 Sw 39Th St , Miramar FL 33027-4614. She recently has only one registered license in Ambulatory Health Care Facilities / Developmental Disabilities, which is considered as her primary health care specialty. Clark, Candace can be contacted via phone (786) 232-2902.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X |
Profile Details
| NPI number | 1821448820 |
|---|---|
| LBN Legal business name | Clark, Candace |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 21st, 2016 |
| Last updated | Jun 21st, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821448820 | NPPES |
| Florida | MEDICAID | 016651300 |
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