# GREGORY L HENDERSON MD FACS INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GREGORY L HENDERSON MD FACS INC
- **Other names:** Florida Eye Specialists and Cataract Institute
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1821082249
- **Legal business name:** GREGORY L HENDERSON MD FACS INC
- **Authorized official:** MR. GREGORY L HENDERSON SR. MD (PRESIDENT)
- **Authorized official phone:** (813) 681-1122

## Contact information

- **Practice address:** 1701 RICKENBACKER DR., STE 102, SUN CITY CENTER, FL 33573-5361
- **Practice address phone:** (813) 634-7788
- **Practice address fax:** (813) 634-2266
- **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 |

## Other

- **Enumeration date:** 08/31/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0609838-02 | — | FL |
| 05 | — | 060983802 | — | FL |