Provider Demographics
NPI:1760666283
Name:SOBEL, ALLEN IRA (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:IRA
Last Name:SOBEL
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 1:12034 W BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-9261
Mailing Address - Country:US
Mailing Address - Phone:352-794-0091
Mailing Address - Fax:
Practice Address - Street 1:12034 W BAYSHORE DR
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-9261
Practice Address - Country:US
Practice Address - Phone:352-794-0091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOP000902152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist