MEDICARE: DR. KAYLA CLARE

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	183500000X	Pharmacist	0202217055	VA
2	183500000X	Pharmacist	PS58988	FL

General Provider Information

NPI Number	:	1902402340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAYLA CLARE

Provider Business Mailing Address
First Line	:	846 NE 54TH TERRACE
Second Line	:
City	:	COLEMAN
State	:	FL
Zip	:	33521
Country	:	US
Telephone Number	:	352-689-5282
Fax Number	:

Provider Business Practice Location Address
First Line	:	6217 SILVER STAR RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-4229
Country	:	US
Telephone Number	:	407-298-0303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2020
Last Update Date	:	12/10/2020

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Directions to “ DR. KAYLA CLARE ” Practice Location

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