Provider Demographics
NPI:1427082478
Name:AFSORDEH, SAHAR (OD)
Entity type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:
Last Name:AFSORDEH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 ULMERTON RD
Mailing Address - Street 2:STE 230
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3514
Mailing Address - Country:US
Mailing Address - Phone:727-586-5888
Mailing Address - Fax:727-585-4205
Practice Address - Street 1:10500 ULMERTON RD
Practice Address - Street 2:SUITE230
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3544
Practice Address - Country:US
Practice Address - Phone:727-586-5888
Practice Address - Fax:727-585-4205
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2019-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3863152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist