Provider Demographics
NPI:1881655645
Name:CHAVEZ, CLAUDIA L (OD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:L
Last Name:CHAVEZ
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 1:2312 HANNAH WAY S
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-9453
Mailing Address - Country:US
Mailing Address - Phone:727-641-7485
Mailing Address - Fax:727-771-1920
Practice Address - Street 1:2629 N FOREST RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-5123
Practice Address - Country:US
Practice Address - Phone:352-527-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0742152W00000X
FLOPC3787152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3759970OtherCIGNA PROVIDER ID
FL68155OtherBCBS-FLORIDA PROVIDER ID
FL7052609OtherAETNA PROVIDER ID
FL620979300Medicaid
FL3759970OtherCIGNA PROVIDER ID
FL620979300Medicaid