| Katherine Ida Clayton, DO | |
|
1000 36th St, Vero Beach, FL 32960-4862 | |
| (772) 567-4311 | |
| (772) 563-4641 |
| Full Name | Katherine Ida Clayton |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1000 36th St, Vero Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780959932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | OS13192 (Florida) | Secondary |
| 208000000X | Pediatrics | OS13192 (Florida) | Primary |
| Entity Name | Pediatrix Medical Group Of Florida Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083711790 PECOS PAC ID: 4486634417 Enrollment ID: O20040721000998 |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine Ida Clayton, DO Po Box 191, Provider Enrollment Dept, Rockland, DE 19732-0191 Ph: (302) 651-6212 | Katherine Ida Clayton, DO 1000 36th St, Vero Beach, FL 32960-4862 Ph: (772) 567-4311 |
William David Caldwell, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1545 9th St Sw, Vero Beach, FL 32962 Phone: 772-257-8224 Fax: 772-213-3157 | |
Dr. Hemant P Gundavda, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1545 9th St Sw, Vero Beach, FL 32962 Phone: 772-257-8224 Fax: 772-213-3157 | |
Lacey Vatland, APRN Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1155 35th Ln Ste 201a, Vero Beach, FL 32960 Phone: 772-562-5662 | |
Mrs. Jessica Lauren Delia, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1155 35th Ln Ste 201a, Vero Beach, FL 32960 Phone: 772-562-5661 Fax: 772-562-5702 | |
Johanna Marisol Dejesus, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 981 37th Pl, Vero Beach, FL 32960 Phone: 772-257-5785 Fax: 772-257-5325 | |
Carmen E Rosado, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 981 37th Pl, Vero Beach, FL 32960 Phone: 772-257-5785 Fax: 772-257-5325 | |
Lori Ann Bowers, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 981 37th Pl, Vero Beach, FL 32960 Phone: 772-257-5785 Fax: 772-257-5325 |