Healthcare Provider Details

I. General information

NPI: 1598134280
Provider Name (Legal Business Name): THE LASIK VISION INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 09/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BISHOP ST STE. 700
HONOLULU HI
96813-3429
US

IV. Provider business mailing address

2000 PALM BEACH LAKES BLVD SUITE 800
WEST PALM BEACH FL
33409-6503
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-9110
  • Fax:
Mailing address:
  • Phone: 800-584-4150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BEN COOK
Title or Position: PRESIDENT
Credential:
Phone: 800-584-4150