Provider Demographics
NPI:1750324638
Name:GIARDINA, JOHN JOSEPH JR (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:GIARDINA
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207
Mailing Address - Country:US
Mailing Address - Phone:941-739-3067
Mailing Address - Fax:941-753-8715
Practice Address - Street 1:4555 14TH ST. W.
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34207
Practice Address - Country:US
Practice Address - Phone:941-739-3067
Practice Address - Fax:941-753-8715
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2352152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME204440767OtherAETNA
MEME02421OtherCIGNA
ME100229OtherANTHEM/BCBS
MEU39278Medicare UPIN
MEU39278Medicare UPIN