Provider Demographics
NPI:1922045384
Name:SARNO, NEVIN M (OD)
Entity Type:Individual
Prefix:DR
First Name:NEVIN
Middle Name:M
Last Name:SARNO
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 1:11650 131ST ST
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-4740
Mailing Address - Country:US
Mailing Address - Phone:727-489-0500
Mailing Address - Fax:727-489-0508
Practice Address - Street 1:10785 102ND AVE
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33778-4211
Practice Address - Country:US
Practice Address - Phone:727-209-3937
Practice Address - Fax:727-394-7393
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC002894152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620254300Medicaid
FLU65361Medicare UPIN
FL20631BMedicare ID - Type UnspecifiedMEDICARE