Provider Demographics
NPI:1437252616
Name:CLAFFIE, KATE (OD)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:
Last Name:CLAFFIE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 N WEST SHORE BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-7222
Mailing Address - Country:US
Mailing Address - Phone:727-491-3786
Mailing Address - Fax:
Practice Address - Street 1:3317 TAMPA RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3426
Practice Address - Country:US
Practice Address - Phone:727-491-3786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC0002876152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620-736-701Medicaid
FL620-736-701Medicaid
FL20744ZMedicare PIN