Provider Demographics
NPI:1780099671
Name:THE LASIK VISION INSTITUTE LLC
Entity type:Organization
Organization Name:THE LASIK VISION INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-584-4150
Mailing Address - Street 1:2000 PLAM BEACH LAKES BLVD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:800-584-4150
Mailing Address - Fax:
Practice Address - Street 1:310 REGENCY PARKWAY
Practice Address - Street 2:SUITE 115
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-391-1026
Practice Address - Fax:402-391-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery