Provider Demographics
NPI:1316238116
Name:PEGGY J STERLING O.D.P.A.
Entity type:Organization
Organization Name:PEGGY J STERLING O.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:J
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-996-2020
Mailing Address - Street 1:29154 CHAPEL PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-4404
Mailing Address - Country:US
Mailing Address - Phone:813-996-2020
Mailing Address - Fax:813-994-1457
Practice Address - Street 1:29154 CHAPEL PARK DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-4404
Practice Address - Country:US
Practice Address - Phone:813-996-2020
Practice Address - Fax:813-994-1457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2758152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL621263801Medicaid