Provider Demographics
NPI:1588703094
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:COO
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:561-965-9110
Mailing Address - Street 1:2000 PALM 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:561-965-9110
Mailing Address - Fax:706-243-4627
Practice Address - Street 1:FIVE CENTERPOINTE DR
Practice Address - Street 2:SUITE 390
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-3398
Practice Address - Country:US
Practice Address - Phone:503-598-7667
Practice Address - Fax:503-598-9156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic SurgeryGroup - Single Specialty