Individual
PHILLIP J. MACKINDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
312 N PARK AVE, WINTER PARK, FL 32789-3305
(407) 644-5156
Mailing address
1592 SOUTH STATE ROAD 15-A, DELAND, FL 32720
(386) 734-2931
(386) 734-2939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20841
BCBS
FL
01
—
410040684
MEDICARE RR
FL
01
—
E0073Z
MEDICARE
FL
Enumeration date
08/22/2005
Last updated
07/07/2026
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