Healthcare Provider Details

I. General information

NPI: 1376548065
Provider Name (Legal Business Name): MICHAEL P CLARE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 BAHIA VISTA ST STE 100
SARASOTA FL
34239-2640
US

IV. Provider business mailing address

2750 BAHIA VISTA ST STE 100
SARASOTA FL
34239-2640
US

V. Phone/Fax

Practice location:
  • Phone: 941-951-2663
  • Fax: 941-552-3312
Mailing address:
  • Phone: 941-951-2663
  • Fax: 941-552-3312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME82208
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberME82208
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: