Provider Demographics
NPI:1780649475
Name:CORDES, SARAH VICTORIA (OD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:VICTORIA
Last Name:CORDES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:VICTORIA
Other - Last Name:PISTULKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8900 SE 165TH MULBERRY
Mailing Address - Street 2:THE VILLAGES VA OUTPATIENT CLINIC
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162
Mailing Address - Country:US
Mailing Address - Phone:352-674-5000
Mailing Address - Fax:352-674-5027
Practice Address - Street 1:8900 SE 165TH MULBERRY LN
Practice Address - Street 2:THE VILLAGES VA OUTPATIENT CLINIC
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5884
Practice Address - Country:US
Practice Address - Phone:352-674-5000
Practice Address - Fax:352-674-5027
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003212152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist