# GREGORY L HENDERSON MD FACS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Optics Soho PA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932434891
- **Authorized official:** MR. GREGORY L HENDERSON SR. M.D. (PRESIDENT)
- **Authorized official phone:** (813) 681-1122

## Contact information

- **Practice address:** 711 S HOWARD AVE, SUITE 120, TAMPA, FL 33606-2465
- **Practice address phone:** (813) 708-5270
- **Practice address fax:** (813) 253-0933
- **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 | OPC2224 | FL | Yes |

## Other

- **Enumeration date:** 10/12/2009
- **Last updated:** 07/12/2023