Organization
GREGORY L HENDERSON MD FACS INC
Active
Parent organization
GREGORY L HENDERSON MD FACS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREGORY L HENDERSON MD FACS INC
Authorized official
MR. GREGORY L HENDERSON SR. MD (PRESIDENT)
(813) 681-1122
Entity
Organization
Contact information
Practice address
5800 49TH ST. N., STE 5108, ST. PETERBURG, FL 33709-2146
(727) 390-3937
(727) 390-3940
Mailing address
403 VONDERBURG DR, BRANDON, FL 33511-5982
(813) 681-1122
(813) 684-4924
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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