Healthcare Provider Details

I. General information

NPI: 1861617177
Provider Name (Legal Business Name): DREW A. SAX O.D.,P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9690 W SAMPLE RD STE 101
CORAL SPRINGS FL
33065-4031
US

IV. Provider business mailing address

11098 HIGHLAND CIR
BOCA RATON FL
33428-2716
US

V. Phone/Fax

Practice location:
  • Phone: 561-705-3917
  • Fax:
Mailing address:
  • Phone: 561-487-2333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2307
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: