Provider Demographics
NPI:1508841594
Name:OCEAN LABS INC
Entity type:Organization
Organization Name:OCEAN LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:305-326-6092
Mailing Address - Street 1:900 NW 17 ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-326-6092
Mailing Address - Fax:305-326-6022
Practice Address - Street 1:900 NW 17 ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-326-6092
Practice Address - Fax:305-326-6022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD00002509152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0876860001Medicare ID - Type Unspecified