Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1700482163 Individual Practitioner Female Practitioner

Leslie A Clark , APRN

Nurse Practitioner • Port Orange, FL

Professional Overview & Biography Verified Profile Summary

Leslie Clark, APRN is a registered healthcare professional specializing in Nurse Practitioner in Port Orange, FL. Practice services are available at 1730 DUNLAWTON AVE STE 1 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1730 Dunlawton Ave Ste 1

Port Orange, FL 321278986

Telephone 3863203299

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Port Orange, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.6 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
21 Specialists

Practicing in Port Orange, FL (8990 Statewide)

Telehealth Adoption Rate
14.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-10-03
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License FL APRN11009779

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Secondary Practice Locations

161 N Causeway Ste C

New Smyrna Beach, FL 321695300

Phone: 3864248440

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Jay Butwinick , APRN

Nurse Practitioner - Family

NPI 1053929190

Advanced Practice Registered Nurse

Christopher Fratangelo , ARNP

Nurse Practitioner - Gerontology

NPI 1780125088

Advanced Registered Nurse Practitioner

Elizabeth Gionest , ARNP

Nurse Practitioner - Family

NPI 1922921642

Advanced Registered Nurse Practitioner

Dr. Hassan Alkhatib , MD

Internal Medicine

NPI 1952630105

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location October 03, 2022

Registered at 1730 DUNLAWTON AVE STE 1, PORT ORANGE, FL 321278986 (Tel: 3863203299)

📍
Updated Business Mailing Address October 03, 2022

Registered at 1730 DUNLAWTON AVE STE 1, PORT ORANGE, FL 321278986 (Tel: 3863203299)

NPI Profile Active December 10, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location December 10, 2020

Registered at 161 N CAUSEWAY STE C, NEW SMYRNA BEACH, FL 321695300 (Tel: 3864248440)

📍
Updated Business Mailing Address December 10, 2020

Registered at 161 N CAUSEWAY STE C, NEW SMYRNA BEACH, FL 321695300 (Tel: 3864248440)

👤
Provider Name / Credentials Updated December 10, 2020

Recorded as LESLIE CLARK, APRN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 10, 2020

Nurse Practitioner (License #APRN11009779 in FL)

🟢
Initial NPI Registration & Enumeration December 09, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1700482163
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 09, 2020
Last Update: October 03, 2022
Sole Proprietor: No

Mailing Address

1730 Dunlawton Ave Ste 1

Port Orange, FL 321278986

Phone: 3863203299

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.