Organization
JENNIFER L. LOAR OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L. LOAR O.D. (OPTOMETRIST/OWNER)
(772) 589-8654
Entity
Organization
Contact information
Practice address
1103 US HIGHWAY 1, STE 2, SEBASTIAN, FL 32958-8660
(772) 589-8654
(772) 581-3870
Mailing address
7785 144TH ST STE A2A, SEBASTIAN, FL 32958-3207
(772) 589-8654
(772) 581-3870
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3138
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20862
BCBS
FL
01
—
DD3585
RR MEDICARE
FL
Enumeration date
01/20/2006
Last updated
06/19/2019
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