# G TIMOTHY PETITO OD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124290515
- **Authorized official:** GUY TIMOTHY PETITO O.D. (OWNER)
- **Authorized official phone:** (727) 578-9880

## Contact information

- **Practice address:** 8695 4TH ST N, ST PETERSBURG, FL 33702-3103
- **Practice address phone:** (727) 578-9880
- **Practice address fax:** (727) 578-1510
- **Mailing address:** 8695 4TH ST N, ST PETERSBURG, FL 33702-3103
- **Mailing address phone:** (727) 578-9880
- **Mailing address fax:** (727) 578-1510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OP0001955 | FL | Yes |

## Other

- **Enumeration date:** 03/26/2008
- **Last updated:** 08/21/2008