Healthcare Provider Details

I. General information

NPI: 1134879018
Provider Name (Legal Business Name): CLAIRE LUCERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CLAIRE SHAFFER MD

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S CONGRESS AVE
ATLANTIS FL
33462-1149
US

IV. Provider business mailing address

1521 S STAPLES ST
CORPUS CHRISTI TX
78404-3150
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-7300
  • Fax: 800-792-9021
Mailing address:
  • Phone: 877-832-2652
  • Fax: 361-371-8376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME173683
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: