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: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 DEL PRADO BLVD
CAPE CORAL FL
33990-2695
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-424-2602
  • Fax: 239-343-1009
Mailing address:
  • Phone: 239-424-2602
  • Fax: 239-343-1009

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 TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME173683
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME173683
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: