Bryan Michael Clark, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS22844 Issued in FL

Practice address

12020 Seminole Blvd
Largo, FL 33778-2805

Phone

(727) 588-9572

NPI assigned

Mar 29, 2022

Sex

Male

Sole proprietor

No

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Suncoast Family Medical AssociatesGroup PAC ID 0941195242, 14 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Suncoast Family Medical Associates

  • Family Medicine Physician
  • Largo, FL
  • NPI 1811981178
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1447990452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782805",
            "telephone_number": "727-588-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 SEMINOLE BLVD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337782805",
            "telephone_number": "727-588-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "BRYAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS22844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk Dominic Cianciolo, D.O
• Nathaniel Marcus Cintron, DO
• Devan Layne Cirino, MSN, APRN, FNP-C
• CJL Anesthesia LLC
• Brandon Connor Clair, MD
• Christine Burns Clark, MD
• Dominique J Clark
• Claudette M Parham (Psychiatric Homecare)
• Jillian Clavenna, PA
• Clean Life Detox

• Family Medicine Physician in Largo, FL
• Providers in Largo, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.