Provider Demographics
NPI:1003024100
Name:INTERNATIONAL OCULAR CENTER INC
Entity Type:Organization
Organization Name:INTERNATIONAL OCULAR CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASSER
Authorized Official - Middle Name:T
Authorized Official - Last Name:BATAINEH
Authorized Official - Suffix:
Authorized Official - Credentials:BCO
Authorized Official - Phone:305-642-3937
Mailing Address - Street 1:4011 W FLAGLER ST
Mailing Address - Street 2:205
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1643
Mailing Address - Country:US
Mailing Address - Phone:305-642-3937
Mailing Address - Fax:305-642-9070
Practice Address - Street 1:4011 W FLAGLER ST
Practice Address - Street 2:205
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1643
Practice Address - Country:US
Practice Address - Phone:305-642-3937
Practice Address - Fax:305-642-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA92-242-04156FX1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0727570001Medicare ID - Type Unspecified