Provider Demographics
NPI:1174819536
Name:GARAY CLAUDIO, MARIA ELENA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:GARAY CLAUDIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 E SAMPLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7574
Mailing Address - Country:US
Mailing Address - Phone:954-943-2100
Mailing Address - Fax:
Practice Address - Street 1:2100 E SAMPLE RD STE 101
Practice Address - Street 2:
Practice Address - City:LIGHTHOUSE POINT
Practice Address - State:FL
Practice Address - Zip Code:33064-7574
Practice Address - Country:US
Practice Address - Phone:954-943-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123385208000000X
PAMT 2004 02208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL150LAOtherBLUE CROSS BLUE SHIELD
FL015234900Medicaid
FL150LAOtherBLUE CROSS BLUE SHIELD