# FLORIDA PEDIATRIC EYE SPECIALISTS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Giacomo S Guggino MD PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770837874
- **Authorized official:** MR. GREGORY L HENDERSON SR. MD (PRESIDENT)
- **Authorized official phone:** (813) 681-1122

## Contact information

- **Practice address:** 3115 W SWANN AVE, TAMPA, FL 33609-4617
- **Practice address phone:** (813) 879-7711
- **Mailing address:** 403 VONDERBURG DR, BRANDON, FL 33511-5982
- **Mailing address phone:** (813) 681-1122
- **Mailing address fax:** (813) 684-4924

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 207WX0110X | Pediatric Ophthalmology and Strabismus Specialist Physician | — | NULL | — |
| 207WX0110X | Pediatric Ophthalmology and Strabismus Specialist Physician | — | — | — |

## Other

- **Enumeration date:** 10/29/2012
- **Last updated:** 08/10/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0537934-00 | — | FL |