# JENNIFER L. LOAR OD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821078163
- **Authorized official:** JENNIFER L. LOAR O.D. (OPTOMETRIST/OWNER)
- **Authorized official phone:** (772) 589-8654

## Contact information

- **Practice address:** 1103 US HIGHWAY 1, STE 2, SEBASTIAN, FL 32958-8660
- **Practice address phone:** (772) 589-8654
- **Practice address fax:** (772) 581-3870
- **Mailing address:** 7785 144TH ST STE A2A, SEBASTIAN, FL 32958-3207
- **Mailing address phone:** (772) 589-8654
- **Mailing address fax:** (772) 581-3870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC3138 | FL | Yes |

## Other

- **Enumeration date:** 01/20/2006
- **Last updated:** 06/19/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 20862 | BCBS | FL |
| 01 | — | DD3585 | RR MEDICARE | FL |