Provider Demographics
NPI:1043876527
Name:PAUL R CLEMENTS PH D ARNP PLLC
Entity Type:Organization
Organization Name:PAUL R CLEMENTS PH D ARNP PLLC
Other - Org Name:BELLEAIR BEHAVIORAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:REEVE
Authorized Official - Last Name:CLEMETNS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APRN
Authorized Official - Phone:727-641-5507
Mailing Address - Street 1:2605 GULF BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLEAIR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33786-3500
Mailing Address - Country:US
Mailing Address - Phone:727-641-5507
Mailing Address - Fax:866-533-1384
Practice Address - Street 1:2605 GULF BLVD
Practice Address - Street 2:
Practice Address - City:BELLEAIR BEACH
Practice Address - State:FL
Practice Address - Zip Code:33786-3500
Practice Address - Country:US
Practice Address - Phone:727-641-5507
Practice Address - Fax:866-533-1384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-10
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9231546OtherDOH