Organization
IDEAL OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED L PUTNAM OPTICIAN (PRESIDENT)
(850) 477-0582
Entity
Organization
Contact information
Practice address
6873A NORTH 9TH AVE, IDEAL OPTICAL INC, PENSACOLA, FL 32504-7349
(850) 477-0582
Mailing address
6873A NORTH 9TH AVE, IDEAL OPTICAL INC, PENSACOLA, FL 32504-7349
(850) 477-0582
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D5664
FLORIDA BS
—
Enumeration date
12/20/2006
Last updated
08/22/2020
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