Provider Demographics
NPI:1932228913
Name:SABRIPOUR, BITA KHALIFIAN (OD)
Entity Type:Individual
Prefix:DR
First Name:BITA
Middle Name:KHALIFIAN
Last Name:SABRIPOUR
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 1:10050 NW 3RD CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7047
Mailing Address - Country:US
Mailing Address - Phone:954-236-5656
Mailing Address - Fax:
Practice Address - Street 1:301 NW 84 AVENUE
Practice Address - Street 2:SUITE 205
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3317
Practice Address - Country:US
Practice Address - Phone:954-236-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3654152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist