Phillips, Jeffrey Dean
Phillips, Jeffrey Dean is an individual health care provider with primary practice located at 1903 Tyrone Blvd N , Saint Petersburg FL 33710-4841. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Phillips, Jeffrey Dean can be contacted via phone (727) 345-4035.Contact Information
Primary practice address
1903 Tyrone Blvd N
Saint Petersburg FL 33710-4841
Phone: (727) 345-4035
Fax: (727) 384-3112
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC2099 | Florida |
Profile Details
| NPI number | 1811974900 |
|---|---|
| LBN Legal business name | Phillips, Jeffrey Dean |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2005 |
| Last updated | Nov 4th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811974900 | NPPES |
| Florida | MEDICAID | 078676400 |
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