# PELT EYE CLINIC, P.A.

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

## Provider details

- **NPI number:** 1336173350
- **Authorized official:** DR. ALAN E PELT OD (PRESIDENT)
- **Authorized official phone:** (850) 482-2336

## Contact information

- **Practice address:** 4340 LAFAYETTE ST, MARIANNA, FL 32446-2916
- **Practice address phone:** (850) 482-2336
- **Practice address fax:** (850) 526-5337
- **Mailing address:** PO BOX 6054, MARIANNA, FL 32447-6054
- **Mailing address phone:** (850) 482-2336
- **Mailing address fax:** (850) 526-5337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | Yes |
| 152W00000X | Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 03/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 620847900 | — | FL |