Provider Demographics
NPI:1932907136
Name:CLARKE, JABBAR AKARI
Entity type:Individual
Prefix:
First Name:JABBAR
Middle Name:AKARI
Last Name:CLARKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16082 WHIPPOORWILL CIR
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-6512
Mailing Address - Country:US
Mailing Address - Phone:561-704-5286
Mailing Address - Fax:
Practice Address - Street 1:16082 WHIPPOORWILL CIR
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-6512
Practice Address - Country:US
Practice Address - Phone:561-704-5286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-04
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037957363LP0808X
FLAPRN11037957363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health