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General NPI Number Information
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NPI Number | 1316228331
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Entity Type | Organization
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Legal Business Name | SARAH A KENNEDY OD PA
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Dates
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Enumeration Date | 09/03/2011
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Last Update Date | 09/03/2011
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Provider Practice Location Address
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Address Line | 8075 SW HIGHWAY 200 SUITE 107
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City | OCALA
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State | FL
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Zip | 34481-7823
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Country | US
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Telephone | 352-369-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 4816 SW 62ND ST
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City | OCALA
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State | FL
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Zip | 34474-4782
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Country | US
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Telephone | 407-373-9599
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARAH A KENNEDY
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Credential | OD
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Telephone | 407-373-9599
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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 | OPC 4288
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License Number State | FL
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