MEDICARE: DR. CLAIRE DENISE GODFREY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	ME79051	FL

General Provider Information

NPI Number	:	1588737076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAIRE DENISE GODFREY M.D.

Provider Business Mailing Address
First Line	:	917 RINEHART RD
Second Line	:	SUITE 2001
City	:	LAKE MARY
State	:	FL
Zip	:	32746-4802
Country	:	US
Telephone Number	:	407-260-8987
Fax Number	:	407-786-8950

Provider Business Practice Location Address
First Line	:	917 RINEHART RD
Second Line	:	SUITE 2001
City	:	LAKE MARY
State	:	FL
Zip	:	32746-4802
Country	:	US
Telephone Number	:	407-260-8987
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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