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

Dr. Michael Lee Clark, DO

Individual provider Diagnostic Radiology Physician · NPI 1457662280

Dr. Michael Lee Clark, DO is a Diagnostic Radiology in Fort Myers, Florida. Qualified in 2010, 16 years ago. Practices with Millennium Physician Group LLC, a 970-clinician group and accepts Medicare assignment. Licensed in Florida and Illinois.

Years since qualifying
16
Licensed in
FL, IL
In the registry since
2010
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

13813 Metro Pkwy
Fort Myers, FL 33912-4343
Phone: (855) 674-4624
Fax: (941) 883-8386
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence OS13601 (FL)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 036132955 (IL)

Record details

NPI number1457662280
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 26, 2010
Last updated in NPPESJanuary 3, 2024
Certification dateJanuary 3, 2024
Mailing address2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Millennium Physician Group Llc — 970 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations28 on file with Medicare

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