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Organization
FLORIDA PEDIATRIC EYE SPECIALISTS, INC
Active
Organization
FLORIDA PEDIATRIC EYE SPECIALISTS, INC
Active
Other names
Giacomo S Guggino MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY L HENDERSON SR. MD (PRESIDENT)
(813) 681-1122
Entity
Organization
Contact information
Practice address
3115 W SWANN AVE, TAMPA, FL 33609-4617
(813) 879-7711
Mailing address
403 VONDERBURG DR, BRANDON, FL 33511-5982
(813) 681-1122
(813) 684-4924
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
—
NULL
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0537934-00
—
FL
Enumeration date
10/29/2012
Last updated
08/10/2021
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