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General NPI Number Information
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NPI Number | 1275129983
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Entity Type | Organization
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Legal Business Name | STELLAR VISION LLC
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Dates
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Enumeration Date | 12/16/2020
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 42041 CYPRESS PKWY UNIT 3
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City | PUNTA GORDA
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State | FL
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Zip | 33982-5140
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Country | US
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Telephone | 239-731-0060
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Fax | 239-731-1286
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Provider Business Mailing Address
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Address Line | 42041 CYPRESS PKWY UNIT 3
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City | PUNTA GORDA
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State | FL
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Zip | 33982-5140
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Country | US
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Telephone | 239-731-0060
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Fax | 239-731-1286
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. JILL SAGONA
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Credential | OD
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Telephone | 239-841-2551
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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 |
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License Number State |
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