Provider Demographics
NPI:1174717680
Name:CLAUDIO, REINALDO (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:REINALDO
Middle Name:
Last Name:CLAUDIO
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1020
Mailing Address - Country:US
Mailing Address - Phone:727-726-8500
Mailing Address - Fax:
Practice Address - Street 1:2720 PARK DR
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1020
Practice Address - Country:US
Practice Address - Phone:727-726-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL150041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUE3160YMedicare UPIN