Provider Demographics
NPI:1952546681
Name:NORDQUIST, CLAY (MD)
Entity type:Individual
Prefix:DR
First Name:CLAY
Middle Name:
Last Name:NORDQUIST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2470 E HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6016
Mailing Address - Country:US
Mailing Address - Phone:352-404-9940
Mailing Address - Fax:352-404-9945
Practice Address - Street 1:2470 E HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6016
Practice Address - Country:US
Practice Address - Phone:352-404-9940
Practice Address - Fax:352-404-9945
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME103291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCM537ZMedicare PIN