Provider Demographics
NPI:1902905219
Name:CLAYMAN, GARY LEE (MD, DMD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:LEE
Last Name:CLAYMAN
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CYPRESS GLEN DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4602
Mailing Address - Country:US
Mailing Address - Phone:813-940-3130
Mailing Address - Fax:813-315-6360
Practice Address - Street 1:2400 CYPRESS GLEN DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4602
Practice Address - Country:US
Practice Address - Phone:813-940-3130
Practice Address - Fax:813-315-6360
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5856207Y00000X
FLME125739208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122800901Medicaid
TX122800901Medicaid
TX82M019Medicare PIN