Provider Demographics
NPI:1578361549
Name:BATISTA, IZA (DO 7702)
Entity type:Individual
Prefix:
First Name:IZA
Middle Name:
Last Name:BATISTA
Suffix:
Gender:
Credentials:DO 7702
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 53RD CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5561
Mailing Address - Country:US
Mailing Address - Phone:786-200-2203
Mailing Address - Fax:
Practice Address - Street 1:53 W 21ST ST STE 7
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-2647
Practice Address - Country:US
Practice Address - Phone:305-696-1415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7702156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician