Florida Pediatric Eye Specialists, Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

FLORIDA PEDIATRIC EYE SPECIALISTS, INC

Practice address

3115 W Swann Ave
Tampa, FL 33609-4617

Phone

(813) 879-7711

NPI assigned

Oct 29, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gregory L Henderson Sr., MD

Title

President

Phone

(813) 681-1122

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Giacomo S Guggino MD PA Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronni M Chen, MD

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Brandon, FL
  • NPI 1215973037
  NPD (past)
• Toni Lynn Licata, O.D.

  • Optometrist
  • Tampa, FL
  • NPI 1245378017
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1770837874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115982",
            "telephone_number": "813-681-1122",
            "fax_number": "813-684-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 W SWANN AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094617",
            "telephone_number": "813-879-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PEDIATRIC EYE SPECIALISTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-29",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-681-1122",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0537934-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Giacomo S Guggino MD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Ophthalmology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.