Provider Demographics
NPI:1982874145
Name:JEFFREY E SAGER OD PA
Entity type:Organization
Organization Name:JEFFREY E SAGER OD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAGER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-476-7631
Mailing Address - Street 1:823 N NOB HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1038
Mailing Address - Country:US
Mailing Address - Phone:954-476-7631
Mailing Address - Fax:954-476-1062
Practice Address - Street 1:823 N NOB HILL RD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1038
Practice Address - Country:US
Practice Address - Phone:954-476-7631
Practice Address - Fax:954-476-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101021152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0620640001Medicare NSC
FLU23576Medicare UPIN