Provider Demographics
NPI:1861617177
Name:SAX, DREW A (OD,PA)
Entity type:Individual
Prefix:DR
First Name:DREW
Middle Name:A
Last Name:SAX
Suffix:
Gender:M
Credentials:OD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11098 HIGHLAND CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2716
Mailing Address - Country:US
Mailing Address - Phone:561-487-2333
Mailing Address - Fax:
Practice Address - Street 1:9690 W SAMPLE RD STE 101
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4031
Practice Address - Country:US
Practice Address - Phone:561-705-3917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2307152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT48662Medicare UPIN