Individual
DR. BRAD R SALOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
570 AVENUE K SE, WINTER HAVEN, FL 33880-4203
(863) 401-4200
(863) 220-9912
Mailing address
570 AVENUE K SE, WINTER HAVEN, FL 33880-4203
(863) 401-4200
(863) 220-9912
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1963
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078610100
—
FL
Enumeration date
09/07/2005
Last updated
06/01/2021
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