Provider Demographics
NPI:1902071970
Name:KENNEDY, SARAH A (OD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:A
Last Name:KENNEDY
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 1:8075 SW HIGHWAY 200
Mailing Address - Street 2:STE 107
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-7823
Mailing Address - Country:US
Mailing Address - Phone:352-369-3937
Mailing Address - Fax:352-236-7006
Practice Address - Street 1:8075 SW HIGHWAY 200
Practice Address - Street 2:STE 107
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7823
Practice Address - Country:US
Practice Address - Phone:352-369-3937
Practice Address - Fax:352-236-7006
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4288152W00000X
GAOPT002436152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist