Provider Demographics
NPI:1235457995
Name:DREW A. SAX, O.D.,P.A.
Entity Type:Organization
Organization Name:DREW A. SAX, O.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAX
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-487-2333
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:954-752-5220
Practice Address - Fax:954-752-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP002307320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6438120001Medicare NSC
FLT48662Medicare UPIN