Healthcare Provider Details

I. General information

NPI: 1003024100
Provider Name (Legal Business Name): INTERNATIONAL OCULAR CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 W FLAGLER ST 205
CORAL GABLES FL
33134-1643
US

IV. Provider business mailing address

4011 W FLAGLER ST 205
CORAL GABLES FL
33134-1643
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-3937
  • Fax: 305-642-9070
Mailing address:
  • Phone: 305-642-3937
  • Fax: 305-642-9070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number92-242-04
License Number StateIA

VIII. Authorized Official

Name: YASSER T BATAINEH
Title or Position: OWNER
Credential: BCO
Phone: 305-642-3937