Gregory L Henderson MD Facs INC

NPI #1306830799 in Ruskin, Florida

Provider Information

NPI Number: 1306830799
Entity Type: Organization
Organization Name: Gregory L Henderson MD Facs INC
Subpart: Yes (part of a larger organization)
Parent Organization: GREGORY L HENDERSON MD FACS INC
Primary Specialty: Optometrist
Enumeration Date: Aug 31, 2005
Last Updated: Sep 19, 2017

Practice Location

Address: 612 N TAMIAMI TRL
City: Ruskin
State: Florida
ZIP Code: 33570-3769
Phone: (813) 645-3831

Authorized Official

Name: MR. GREGORY L HENDERSON SR., MD
Title: PRESIDENT
Phone: (813) 681-1122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X
Optometrist	152W00000X	Primary

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