Basic Information
| Provider Information | |||||||||
| NPI: | 1912271768 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLARK HOWARD | ||||||||
| FirstName: | FRANCES | ||||||||
| MiddleName: | SHOLER | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1608 SE 3 AVENUE | ||||||||
| Address2: | THIRD FLOOR CBO/PBS | ||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333162564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548474572 | ||||||||
| FaxNumber: | 9548474176 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 S FEDERAL HWY | ||||||||
| Address2: | |||||||||
| City: | FORT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333162619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547288080 | ||||||||
| FaxNumber: | 9547791957 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2012 | ||||||||
| LastUpdateDate: | 05/16/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | RN 9191185 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | Y014E | 01 | FL | BCBS | OTHER |