Provider Demographics
NPI:1760415905
Name:HUGGETT, EDWARD JOSEPH JR (OD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:HUGGETT
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:924 LINN HARBOR CT
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-5703
Mailing Address - Country:US
Mailing Address - Phone:727-789-0199
Mailing Address - Fax:727-789-1767
Practice Address - Street 1:2323 CURLEW RD STE 7A
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-9332
Practice Address - Country:US
Practice Address - Phone:727-463-2579
Practice Address - Fax:727-934-4409
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2447152W00000X, 152WV0400X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20231OtherBLUE CROSS BLUE SHIELD OF FLORIDA
FL078857100Medicaid
FLU10123Medicare UPIN
FL20231OtherBLUE CROSS BLUE SHIELD OF FLORIDA