Provider Demographics
NPI:1659670495
Name:BATISTA, WENDY M (OD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:M
Last Name:BATISTA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13132 SW 54TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5402
Mailing Address - Country:US
Mailing Address - Phone:305-233-2447
Mailing Address - Fax:
Practice Address - Street 1:10071 W FLAGLER ST
Practice Address - Street 2:STE C 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-1825
Practice Address - Country:US
Practice Address - Phone:305-223-2447
Practice Address - Fax:305-223-2448
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2216152W00000X
VA0618002074152W00000X
NJ27OA00636600152W00000X
FLOPC 4784152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist