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NPI Code Detail

MEDICARE: SARAH REGAL, OD, LLC

MEDICARE: SARAH REGAL, OD, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

General Provider Information

NPI Number : 1891347910
Entity Type Code : Organization
Provider Name (Legal Business Name) : SARAH REGAL, OD, LLC
Provider Business Mailing Address
First Line : 2141 RIDGE RD S LOT 28
Second Line :
City : LARGO
State : FL
Zip : 33778-1615
Country : US
Telephone Number : 903-503-3187
Fax Number :
Provider Business Practice Location Address
First Line : 10041 US HIGHWAY 19 STE A
Second Line :
City : PORT RICHEY
State : FL
Zip : 34668-3785
Country : US
Telephone Number : 833-209-7114
Fax Number : 727-857-4365
Authorized Official
Title or Position : OPTOMETRIST/OWNER
Name : SARAH G REGAL
Credential : OD
Telephone Number : 903-503-3187
Provider Enumeration Date : 07/09/2019
Last Update Date : 07/09/2019

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Directions to “SARAH REGAL, OD, LLC ” Practice Location

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