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General NPI Number Information
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NPI Number | 1902402340
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Entity Type | Individual
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Provider Name | DR. KAYLA CLARE
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Gender | Female
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 6217 SILVER STAR RD
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City | ORLANDO
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State | FL
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Zip | 32808-4229
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Country | US
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Telephone | 407-298-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 846 NE 54TH TERRACE
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City | COLEMAN
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State | FL
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Zip | 33521
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Country | US
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Telephone | 352-689-5282
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202217055
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS58988
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License Number State | FL
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