# JEFFREY D. PHILLIPS, O.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifetime Vision Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649362989
- **Authorized official:** DR. JEFFREY DEAN PHILLIPS O.D. (PRESIDENT)
- **Authorized official phone:** (727) 345-4035

## Contact information

- **Practice address:** 1903 TYRONE BOULEVARD N, SAINT PETERSBURG, FL 33710-4841
- **Practice address phone:** (727) 345-4035
- **Practice address fax:** (727) 384-3112
- **Mailing address:** 1903 TYRONE BOULEVARD N, SAINT PETERSBURG, FL 33710-4841
- **Mailing address phone:** (727) 345-4035
- **Mailing address fax:** (727) 384-3112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC 2099 | FL | Yes |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 11/10/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 620359100 | — | FL |