Provider Demographics
NPI:1730282849
Name:DR. SEAN CLAFFIE AND ASSOCIATES, O.D., P.A.
Entity Type:Organization
Organization Name:DR. SEAN CLAFFIE AND ASSOCIATES, O.D., P.A.
Other - Org Name:ALSO DBA EYEDOCSOPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:727-491-3786
Mailing Address - Street 1:3317 TAMPA RD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3426
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC0003100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4004OtherMEDICARE PTAN
FLK4004OtherMEDICARE PTAN