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DR. PHILIP BENEDICT GUASTELLA OD

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1952475006

Individual Registrant:
DR. PHILIP BENEDICT GUASTELLA OD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
17030 US HWY 441  MT DORA, FL 32757-6733 US
Tel: 352-735-2030  Fax: 352-735-0218

Contact information for business:
18102 VICTORIAN DRIVE  CLERMONT, FL 34715-7743 US
Tel: 352-241-0181  Fax: --

Registration Information:
NPI: 1952475006
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
FLOP2903

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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