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General NPI Number Information
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NPI Number | 1104440437
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Entity Type | Individual
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Provider Name | SAHAR ELTALLA OD
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Gender | Female
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Dates
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Enumeration Date | 06/02/2020
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 5601 NW 183RD ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33055-2305
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Country | US
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Telephone | 305-760-7008
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Fax |
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Provider Business Mailing Address
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Address Line | 4700 SW 160TH AVE APT 419
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City | MIRAMAR
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State | FL
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Zip | 33027-5716
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Country | US
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Telephone | 954-805-1443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC5825
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License Number State | FL
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