Provider Demographics
NPI:1942920053
Name:SIGHTCRAFT EYECARE AND CUSTOM OPTICAL
Entity Type:Organization
Organization Name:SIGHTCRAFT EYECARE AND CUSTOM OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-536-0813
Mailing Address - Street 1:1527 S FLAGLER DR APT 211F
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-7144
Mailing Address - Country:US
Mailing Address - Phone:954-536-0813
Mailing Address - Fax:
Practice Address - Street 1:540A NORTHWOOD RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-5818
Practice Address - Country:US
Practice Address - Phone:954-536-0813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty