Provider Demographics
NPI:1346890704
Name:BATISTA, MORAIMA IRENE (MD)
Entity type:Individual
Prefix:DR
First Name:MORAIMA
Middle Name:IRENE
Last Name:BATISTA
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:MORAIMA
Other - Middle Name:IRENE
Other - Last Name:BATISTA CARMONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:
Practice Address - Street 1:6710 HANLEY RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4743
Practice Address - Country:US
Practice Address - Phone:813-284-7903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21560208D00000X
FLTN42695246RH0600X
FLACN1212208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No246RH0600XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyHistology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLTN42695OtherASCP