Salomon, Brad R
Salomon, Brad R is an individual health care provider with primary practice located at 570 Avenue K Se , Winter Haven FL 33880-4203. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Salomon, Brad R can be contacted via phone (863) 401-4200.Contact Information
Primary practice address
570 Avenue K Se
Winter Haven FL 33880-4203
Phone: (863) 401-4200
Fax: (863) 220-9912
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC1963 | Florida |
Profile Details
| NPI number | 1851385710 |
|---|---|
| LBN Legal business name | Salomon, Brad R |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 7th, 2005 |
| Last updated | Jun 1st, 2021 - about 3 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 | 1851385710 | NPPES |
| Florida | MEDICAID | 078610100 |
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