# ICUC OPTOMETRIST, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134420029
- **Authorized official:** DR. DINA ISKANDER O.D. (PRESIDENT)
- **Authorized official phone:** (954) 895-9748

## Contact information

- **Practice address:** 432 NW 105TH DR, CORAL SPRINGS, FL 33071-7916
- **Practice address phone:** (954) 895-9748
- **Mailing address:** 3860 VICTORY BLVD, STATEN ISLAND, NY 10314-6720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC4448 | FL | Yes |

## Other

- **Enumeration date:** 11/08/2010
- **Last updated:** 12/07/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00256000 | — | FL |