Provider Demographics
NPI:1588737076
Name:GODFREY, CLAIRE DENISE (MD)
Entity type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:DENISE
Last Name:GODFREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:917 RINEHART RD
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4802
Mailing Address - Country:US
Mailing Address - Phone:407-260-8987
Mailing Address - Fax:407-786-8950
Practice Address - Street 1:917 RINEHART RD
Practice Address - Street 2:SUITE 2001
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4802
Practice Address - Country:US
Practice Address - Phone:407-260-8987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79051207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH25001Medicare UPIN