Provider Demographics
NPI:1588292882
Name:CLARITY DX, INC.
Entity type:Organization
Organization Name:CLARITY DX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:FETHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-385-3136
Mailing Address - Street 1:1111 LATTA LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-6335
Mailing Address - Country:US
Mailing Address - Phone:727-385-3136
Mailing Address - Fax:
Practice Address - Street 1:1111 LATTA LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-6335
Practice Address - Country:US
Practice Address - Phone:727-385-3136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization