Provider Demographics
NPI:1346895422
Name:PAWLAK, CLAYTON (OD)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:
Last Name:PAWLAK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2471 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-6853
Mailing Address - Country:US
Mailing Address - Phone:954-943-3606
Mailing Address - Fax:954-943-3569
Practice Address - Street 1:2471 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-6853
Practice Address - Country:US
Practice Address - Phone:954-943-3606
Practice Address - Fax:954-943-3569
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5730152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist