Lola Gene Clark, MS/CCC-SLP is a
Speech-language Pathologist based in Fort Myers Beach, Florida. Lola Gene Clark is licensed to practice in Florida (license number SA 11850) and her current practice location is
4560 Estero Blvd, #202, Fort Myers Beach, Florida. She can be reached at her office (for appointments etc.) via phone at
(260) 437-2385.
NPI number for Lola Gene Clark is 1477991172 and her current mailing address is 4560 Estero Blvd, #202, Fort Myers Beach, Florida. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1477991172.
Healthcare Provider's Profile
Full Name | Lola Gene Clark |
---|
Gender | Female |
---|
Speciality | Speech-language Pathologist |
---|
Location | 4560 Estero Blvd, Fort Myers Beach, Florida |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1477991172
- Provider Enumeration Date: 06/05/2013
- Last Update Date: 06/05/2013
Medical Identifiers
Medical identifiers for Lola Gene Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477991172 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
235Z00000X | Speech-language Pathologist | SA 11850 (Florida) | 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. Lola Gene 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 |
Lola Gene Clark, MS/CCC-SLP 4560 Estero Blvd, #202, Fort Myers Beach, FL 33931-3947 Ph: (260) 437-2385 | Lola Gene Clark, MS/CCC-SLP 4560 Estero Blvd, #202, Fort Myers Beach, FL 33931-3947 Ph: (260) 437-2385 |
Reviews and Comments