Organization
GREGORY L HENDERSON MD FACS INC
Active
Parent organization
GREGORY L HENDERSON MD FACS INC
Other names
Florida Eye Specialists and Cataract Institute
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
1701 RICKENBACKER DR., STE 102, SUN CITY CENTER, FL 33573-5361
(813) 634-7788
(813) 634-2266
Mailing address
403 VONDERBURG DR, BRANDON, FL 33511-5982
(813) 681-1122
(813) 684-4924
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0609838-02
—
FL
05
—
060983802
—
FL
Enumeration date
08/31/2005
Last updated
07/21/2022
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