# VIRATA RETINA CENTER LLC

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

## Provider details

- **NPI number:** 1518531649
- **Authorized official:** STEVEN R VIRATA MD (OWNER)
- **Authorized official phone:** (765) 573-8462

## Contact information

- **Practice address:** 150 PROFESSIONAL CT STE A, LAFAYETTE, IN 47905-5153
- **Practice address phone:** (765) 573-8462
- **Mailing address:** 150 PROFESSIONAL CT STE A, LAFAYETTE, IN 47905-5153
- **Mailing address phone:** (765) 573-8462
- **Mailing address fax:** (765) 767-4818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/13/2021
- **Last updated:** 10/21/2021