Provider Demographics
NPI:1194165688
Name:PHILLIPS, DAVID ALEXANDER (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALEXANDER
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 E ATLANTIC BLVD # 1385
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-4939
Mailing Address - Country:US
Mailing Address - Phone:714-345-6084
Mailing Address - Fax:
Practice Address - Street 1:822 DEL PRADO BLVD S STE 120
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2687
Practice Address - Country:US
Practice Address - Phone:941-295-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14976207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine