Organization
PHILLIPS SALOMON & PARRISH PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD R SALOMON OD (REGISTERED AGENT)
(863) 299-8908
Entity
Organization
Contact information
Practice address
4337 S FLORIDA AVE, LAKELAND, FL 33813-1654
(863) 619-6900
(863) 648-4679
Mailing address
215 1ST ST N, SUITE 100, WINTER HAVEN, FL 33881-4537
(863) 299-8908
(863) 299-1061
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078873201
—
FL
Enumeration date
09/29/2005
Last updated
02/08/2011
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