Provider Demographics
NPI:1376548065
Name:CLARE, MICHAEL P (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:CLARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 BAHIA VISTA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2640
Mailing Address - Country:US
Mailing Address - Phone:941-951-2663
Mailing Address - Fax:941-552-3312
Practice Address - Street 1:2750 BAHIA VISTA ST STE 100
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2640
Practice Address - Country:US
Practice Address - Phone:941-951-2663
Practice Address - Fax:941-552-3312
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82208207XX0004X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01562OtherBCBSFL
FL271867700Medicaid
FL7452373OtherAETNA
FL278501OtherAVMED
FL1674442OtherCIGNA
FL200041781OtherRAILROAD MEDICARE
FL1674442OtherCIGNA
FL7452373OtherAETNA