Organization
ICUC OPTOMETRIST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DINA ISKANDER O.D. (PRESIDENT)
(954) 895-9748
Entity
Organization
Contact information
Practice address
432 NW 105TH DR, CORAL SPRINGS, FL 33071-7916
(954) 895-9748
Mailing address
3860 VICTORY BLVD, STATEN ISLAND, NY 10314-6720
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4448
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00256000
—
FL
Enumeration date
11/08/2010
Last updated
12/07/2011
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