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
5528 US HIGHWAY 98 N, LAKELAND, FL 33809-3104
(863) 853-2020
(863) 595-2838
Mailing address
215 1ST ST N, 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
—
078873203
—
FL
Enumeration date
09/13/2005
Last updated
02/09/2011
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