Kena Anthony Clarke, ORTHOPAEDIC TECH

Primary specialty

Orthopedic AssistantTaxonomy code 246ZX2200X

License

13-0212 Issued in FL

Practice address

4700 Sheridan St
Hollywood, FL 33021-3420

Phone

(954) 961-3500

Fax

(954) 961-1835

NPI assigned

Mar 24, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1194428516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7650 FARRAGUT ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242628",
            "telephone_number": "954-857-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213420",
            "telephone_number": "954-961-3500",
            "fax_number": "954-961-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "KENA",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "ORTHOPAEDIC TECH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-24",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZX2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Orthopedic Assistant",
            "state": "FL",
            "license": "13-0212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clara Peicher de Fleischer PA
• Stacy Lea Clark Bergeron Carter, APRN
• Gabrielle Marie Clark, MS
• Kevin Dewitt Clark, AP
• Rita Clark, LCSW
• Lamont Clarke
• Daniel Claro Velazquez
• Kristopher Claros
• Claudia a Draizin DMD PA
• Tiffany N Clausen, FNP-C

• Other Specialist/Technologist in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Other Specialist/Technologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.