Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Demetria Angelica Clark, PA

Individual provider Physician Assistant · NPI 1104399849

Demetria Angelica Clark, PA is a Physician Assistant in Jacksonville, Florida. Licensed in Florida and Minnesota. Registered with an NPI since 2019.

Licensed in
FL, MN
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone: (904) 953-2000
Fax: (904) 956-0381
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9114358 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 12918 (MN)

Record details

NPI number1104399849
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 4, 2019
Last updated in NPPESDecember 21, 2023
Certification dateDecember 21, 2023

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