Basic Information
Provider Information
NPI: 1932655859
EntityType: 2
ReplacementNPI:  
OrganizationName: THE CATARACT VISION INSTITUTE LLC
LastName:  
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Mailing Information
Address1: 1555 PALM BEACH LAKES BLVD
Address2: SUITE 600
City: WEST PALM BEACH
State: FL
PostalCode: 334012323
CountryCode: US
TelephoneNumber: 5619659110
FaxNumber:  
Practice Location
Address1: 310 REGENCY PKWY
Address2: SUITE 115
City: OMAHA
State: NE
PostalCode: 681143791
CountryCode: US
TelephoneNumber: 4023911026
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/31/2016
LastUpdateDate: 08/31/2016
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: COOK
AuthorizedOfficialFirstName: BEN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 5619659110
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QS0132X  Y Ambulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery

No ID Information.


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