Provider Demographics
NPI:1902577513
Name:CLAVETTE-LACHAPELLE, LUDOVIC
Entity Type:Individual
Prefix:
First Name:LUDOVIC
Middle Name:
Last Name:CLAVETTE-LACHAPELLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28955 VERMILLION LN
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-8592
Mailing Address - Country:US
Mailing Address - Phone:248-404-8854
Mailing Address - Fax:
Practice Address - Street 1:878 109TH AVE N # 2
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1814
Practice Address - Country:US
Practice Address - Phone:239-513-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant