Provider Demographics
NPI:1417416975
Name:MIRAMAR EYE CENTER LLC
Entity Type:Organization
Organization Name:MIRAMAR EYE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SALAHUDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-326-0423
Mailing Address - Street 1:6448 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2138
Mailing Address - Country:US
Mailing Address - Phone:954-431-2020
Mailing Address - Fax:954-435-7124
Practice Address - Street 1:6448 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-2138
Practice Address - Country:US
Practice Address - Phone:954-431-2020
Practice Address - Fax:954-435-7124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty