Provider Demographics
NPI:1316105059
Name:AMANDIP SINGH SAPPAL 2, O.D., P.A.
Entity type:Organization
Organization Name:AMANDIP SINGH SAPPAL 2, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDIP
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:SAPPAL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-755-3750
Mailing Address - Street 1:9840 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4006
Mailing Address - Country:US
Mailing Address - Phone:954-755-3750
Mailing Address - Fax:954-252-8882
Practice Address - Street 1:9840 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4006
Practice Address - Country:US
Practice Address - Phone:954-755-3750
Practice Address - Fax:954-252-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3739152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty