Provider Demographics
NPI:1053540385
Name:SUSAN SLOAN OD
Entity type:Organization
Organization Name:SUSAN SLOAN OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:041-365-2060
Mailing Address - Street 1:500 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-7502
Mailing Address - Country:US
Mailing Address - Phone:941-365-2060
Mailing Address - Fax:941-366-6480
Practice Address - Street 1:500 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7502
Practice Address - Country:US
Practice Address - Phone:941-365-2060
Practice Address - Fax:941-366-6480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1561152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty