Provider Demographics
NPI:1235648544
Name:IZA OPTICAL LAB INC
Entity Type:Organization
Organization Name:IZA OPTICAL LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMARILIS
Authorized Official - Middle Name:T
Authorized Official - Last Name:BATISTA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:305-696-1415
Mailing Address - Street 1:950 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3404
Mailing Address - Country:US
Mailing Address - Phone:305-696-1415
Mailing Address - Fax:305-696-3999
Practice Address - Street 1:950 E 25TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3404
Practice Address - Country:US
Practice Address - Phone:305-696-1415
Practice Address - Fax:305-696-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier