Individual
MR. CHARLES EDWARD PORCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2650 CREIGHTON RD, PENSACOLA, FL 32504-7382
(850) 479-1422
(850) 479-1419
Mailing address
32 BLITHEWOOD DR, PENSACOLA, FL 32514-8193
(850) 479-1422
(850) 479-1419
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1496
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002346900
—
FL
Enumeration date
03/22/2007
Last updated
01/15/2016
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