Provider Demographics
NPI:1710556733
Name:MCCABE, CLAIRA
Entity Type:Individual
Prefix:
First Name:CLAIRA
Middle Name:
Last Name:MCCABE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 BUCHANAN PL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8508
Mailing Address - Country:US
Mailing Address - Phone:717-669-2645
Mailing Address - Fax:
Practice Address - Street 1:1904 S MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5903
Practice Address - Country:US
Practice Address - Phone:727-534-9085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2023-10-26
Deactivation Date:2023-10-08
Deactivation Code:
Reactivation Date:2023-10-18
Provider Licenses
StateLicense IDTaxonomies
FL24648225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist