Individual
JENNIFER LOAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
7785 144TH ST STE A2A, SEBASTIAN, FL 32958-3207
(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
OP0003138
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20862
BLUE CROSS
FL
01
—
410049883
RR MEDICARE
FL
Enumeration date
11/07/2006
Last updated
06/19/2019
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