MEDICARE: DR. SEAN CLAFFIE AND ASSOCIATES, O.D., P.A.

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	152W00000X	Optometrist	OPC0003100	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K4004	OTHER	FL	MEDICARE PTAN

General Provider Information

NPI Number	:	1730282849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. SEAN CLAFFIE AND ASSOCIATES, O.D., P.A.

Provider Business Mailing Address
First Line	:	3317 TAMPA RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3426
Country	:	US
Telephone Number	:	727-491-3786
Fax Number	:

Provider Business Practice Location Address
First Line	:	3317 TAMPA RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3426
Country	:	US
Telephone Number	:	727-491-3786
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/MEDICAL DIRECTOR
Name	:	DR. KATE CLAFFIE
Credential	:	O.D.
Telephone Number	:	727-491-3786

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	10/28/2010

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