Provider Demographics
NPI:1427105410
Name:STERLING, PEGGY J (OD)
Entity type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:J
Last Name:STERLING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:PEGGY
Other - Middle Name:J
Other - Last Name:STERLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP0002758152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU55210Medicare UPIN