Philip Benedict Guastella, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP2903 Issued in FL

Practice address

17030 US Hwy 441
Mt Dora, FL 32757-6733

Phone

(352) 735-2030

Fax

(352) 735-0218

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Philip Guastella Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952475006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18102 VICTORIAN DRIVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347157743",
            "telephone_number": "352-241-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17030 US HWY 441",
            "city": "MT DORA",
            "state": "FL",
            "postal_code": "327576733",
            "telephone_number": "352-735-2030",
            "fax_number": "352-735-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUASTELLA",
        "first_name": "PHILIP",
        "middle_name": "BENEDICT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP2903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHILIP",
            "last_name": "GUASTELLA",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jeffrey S. Greenwald, M.D.
• Brenda Rena Grier, ARNPC
• Heather Griffin
• Christine Griggs, RBT
• Jessica Groover
• Rachelle Guerra
• Samir C Guru, D.O.
• Debra Gwynn, MS
• Daisy Lynn Hache, BT
• Anthony A Hackett

• Optometrist in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.