Vivienne M Clarke, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME112465 Issued in FL

Practice address

12196 County Road 512
Fellsmere, FL 32948-5463

Phone

(772) 257-8224

Fax

(772) 213-3157

NPI assigned

Jan 27, 2009

Last updated

May 28, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1477791630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 9TH ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624312",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12196 COUNTY ROAD 512",
            "city": "FELLSMERE",
            "state": "FL",
            "postal_code": "329485463",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 Medical Plaza Drive",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "327711047",
            "country_code": "US",
            "telephone_number": "407-249-1234",
            "fax_number": "407-249-1755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6910 Old Wolf Bay Rd",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321776800",
            "country_code": "US",
            "telephone_number": "386-328-7337",
            "fax_number": "386-325-3742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "VIVIENNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME112465",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT-193978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME112465",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raisa W Arana, DDS
• Veronica Areyan
• Claudia M Boyarski
• Christy Love Celestie, CERTIFIED NURSING
• Pamela J Corkum, LICSW
• Dawn M Fassett
• Michael P Ferrentino, ED.D., L.M.H.C.
• Jane E Guiles, LCSW
• Lisa Cynthia Hage, M.D.

• Pediatrics Physician in Fellsmere, FL
• Providers in Fellsmere, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.