Provider Demographics
NPI:1780696435
Name:ALPHA OPTICAL INC
Entity type:Organization
Organization Name:ALPHA OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-386-4447
Mailing Address - Street 1:2160 CAPITAL CIR NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4390
Mailing Address - Country:US
Mailing Address - Phone:850-386-4447
Mailing Address - Fax:850-422-0201
Practice Address - Street 1:2160 CAPITAL CIR NE
Practice Address - Street 2:SUITE 100
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4390
Practice Address - Country:US
Practice Address - Phone:850-386-4447
Practice Address - Fax:850-422-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1095680001Medicare ID - Type Unspecified