Provider Demographics
NPI:1619062148
Name:BATISTA, AMARILIS T (OD)
Entity type:Individual
Prefix:MRS
First Name:AMARILIS
Middle Name:T
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 1:12732 SW 53 CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027
Mailing Address - Country:US
Mailing Address - Phone:305-826-0719
Mailing Address - Fax:305-696-3999
Practice Address - Street 1:950 E 25 ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013
Practice Address - Country:US
Practice Address - Phone:305-696-1415
Practice Address - Fax:305-696-3999
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO516156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician