Provider Demographics
NPI:1699750489
Name:CLIFFORD, PHILIP E (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:E
Last Name:CLIFFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 N ROCKY POINT DR W STE 160
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5901
Mailing Address - Country:US
Mailing Address - Phone:813-281-0567
Mailing Address - Fax:
Practice Address - Street 1:3030 N ROCKY POINT DR W STE 160
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5901
Practice Address - Country:US
Practice Address - Phone:813-281-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701725207X00000X
FLME134081207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891247RMedicaid
NC891247RMedicaid
NC2280043AMedicare PIN