Provider Demographics
NPI:1053398446
Name:CLAUDEL, CHRISTOPHER DREW (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DREW
Last Name:CLAUDEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15051 S TAMIAMI TRL STE 203
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5182
Mailing Address - Country:US
Mailing Address - Phone:239-313-2517
Mailing Address - Fax:239-666-3051
Practice Address - Street 1:19527 HIGHLAND OAKS DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-9582
Practice Address - Country:US
Practice Address - Phone:813-514-8985
Practice Address - Fax:813-514-8983
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME136972207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5798760OtherAETNA
FL8597929OtherCIGNA
FLP98OZOtherFL BLUE
FL001897209OtherUNITED HC
FL102516700Medicaid