Provider Demographics
NPI:1174510606
Name:SINGER, SAMUEL DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:DAVID
Last Name:SINGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-3781
Mailing Address - Country:US
Mailing Address - Phone:407-892-6200
Mailing Address - Fax:407-892-8643
Practice Address - Street 1:1033 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-3781
Practice Address - Country:US
Practice Address - Phone:407-892-6200
Practice Address - Fax:407-892-8643
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1560152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0475800001OtherPALMETTO GBA MEDICARE
0475800001OtherPALMETTO GBA MEDICARE
FLT93869Medicare UPIN