Individual provider · Type 1 NPI

Desra Kay Clark, DO

Adult Medicine Physician · Cocoa, FL

NPI number 1477816601 Active

Practice location

7227 N US Highway 1
Cocoa, FL 32927-5020

Call (321) 877-2740 Map

Fax (321) 877-2793

Mailing address

PO Box 1137
Melbourne, FL 32902-1137

Specialties and licenses

TaxonomyCodeLicense
Adult Medicine Physician Primary 207QA0505XOS12364 (FL)

Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.

18 other providers at this address

About NPI 1477816601

Desra Kay Clark, DO's National Provider Identifier is 1477816601, issued on Jun 22, 2012. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Cocoa, FL. The record was last updated on Jul 21, 2022.