Provider Demographics
NPI:1629623012
Name:SOKOL, OLGA (OD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:SOKOL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 SALT MEADOW CIR UNIT 107
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1887
Mailing Address - Country:US
Mailing Address - Phone:917-621-6197
Mailing Address - Fax:
Practice Address - Street 1:3520 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-1310
Practice Address - Country:US
Practice Address - Phone:727-369-0043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-02
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC005728152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist