Organization
TITUSVILLE OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID ALLEN BRESSETTE LDO (PRESIDENT OPTICIAN)
(321) 383-1267
Entity
Organization
Contact information
Practice address
1917 KNOX MCRAE DR, TITUSVILLE, FL 32780
(321) 383-1267
(321) 567-0999
Mailing address
1917 KNOX MCRAE DR, TITUSVILLE, FL 32780
(321) 383-1267
(321) 567-0999
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
DO3755
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D7802
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/02/2006
Last updated
08/22/2020
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