Individual provider Active NPI

Stephanie Donoso Clark, MD

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Leesburg, FL
National Provider Identifier
1487276614
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
ME165643 Issued in FL
Practice address
1414 E Main St Ste 2
Leesburg, FL 34748-5399
Phone
(352) 775-2055
Fax
(352) 901-6954
NPI assigned
May 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME165643 FL
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X ME165643 FL Primary

Addresses

Primary practice location

1414 E Main St Ste 2
Leesburg, FL 34748-5399

Mailing address

1414 E Main St Ste 2
Leesburg, FL 34748-5399
Phone (352) 775-2055

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231122000039 FL Practitioner - Family Practice 7810310695 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curelogics Wound Care and Hyperbaric LLCGroup PAC ID 8820335854, 3 clinicians

Practice addresses (Care Compare)

809 County Rd
466 Unit C 201
Lady Lake, FL 32159-4205
Phone (352) 775-2055

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue316
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME165643FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hni Medical Services of Florida, LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Hni Hospital Services of Florida, LLC Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Curelogics Wound Care and Hyperbaric LLC Undersea and Hyperbaric Medicine CurrentSince Jan 1, 2025 Accepting new patients
Hospital Physician Services of Florida PA Family Medicine CurrentSince Nov 6, 2023 Accepting new patients
Yuma Regional Medical Center PastSince Oct 1, 2023 Accepting new patients

Locations

900 N Robert Ave
Arcadia, FL 34266
Phone (863) 494-8426

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

820 S Bea Ave
Inverness, FL 34452
Phone (352) 637-1919

4901 Richard St
Jacksonville, FL 32207
Phone (904) 425-0500

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

809 Highway 466
Ste 201C
Lady Lake, FL 32159

1414 E Main St
Ste 2
Leesburg, FL 34748
Phone (352) 775-2055

611 Zeagler Dr
Palatka, FL 32177
Phone (386) 326-8070

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

1700 Tamiami Trl
Sarasota, FL 34239
Phone (941) 917-8507

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1487276614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E MAIN ST STE 2",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485399",
            "telephone_number": "352-775-2055",
            "fax_number": "352-901-6954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E MAIN ST STE 2",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485399",
            "telephone_number": "352-775-2055",
            "fax_number": "352-901-6954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "STEPHANIE",
        "middle_name": "DONOSO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME165643",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "FL",
            "license": "ME165643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.