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NPI Code Detail

MEDICARE: PHILLIPS SALOMON & PARRISH PA

MEDICARE: PHILLIPS SALOMON & PARRISH PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013904721
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILLIPS SALOMON & PARRISH PA
Provider Business Mailing Address
First Line : 215 1ST ST N
Second Line : SUITE 100
City : WINTER HAVEN
State : FL
Zip : 33881-4537
Country : US
Telephone Number : 863-299-8908
Fax Number : 863-299-1061
Provider Business Practice Location Address
First Line : 1251 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-4673
Country : US
Telephone Number : 863-688-1545
Fax Number : 863-595-0927
Authorized Official
Title or Position : REGISTERED AGENT
Name : DR. BRAD R SALOMON
Credential : OD
Telephone Number : 863-299-8908
Provider Enumeration Date : 09/29/2005
Last Update Date : 02/08/2011

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Directions to “PHILLIPS SALOMON & PARRISH PA ” Practice Location

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