Provider Demographics
NPI:1255742979
Name:DR JOHN J GIARDINA OD AND ASSOCIATES OPTOMETRIC PHYSICIANS PLC
Entity type:Organization
Organization Name:DR JOHN J GIARDINA OD AND ASSOCIATES OPTOMETRIC PHYSICIANS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:GIARDINA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:941-953-5522
Mailing Address - Street 1:320 BERNARD AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-1904
Mailing Address - Country:US
Mailing Address - Phone:941-923-9533
Mailing Address - Fax:941-924-0382
Practice Address - Street 1:3301 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-1305
Practice Address - Country:US
Practice Address - Phone:727-821-9540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2352152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHV427AMedicare PIN