Healthcare Provider Details

I. General information

NPI: 1093757585
Provider Name (Legal Business Name): GIACOMO S. GUGGINO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3115 W SWANN AVE
TAMPA FL
33609-4617
US

IV. Provider business mailing address

3109 W SWANN AVE
TAMPA FL
33609-4617
US

V. Phone/Fax

Practice location:
  • Phone: 813-492-2020
  • Fax: 813-492-2099
Mailing address:
  • Phone: 813-876-1400
  • Fax: 813-876-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME14464
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME14464
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME14464
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: