NPI | 1316249824 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY E GOBERVILLE Pres/Optometrist 954-344-3937 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: FL opc2575) |
Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: FM opc2575) |
152WS0006X Optometrist, Sports Vision (Licence: FL opc2575) | |
152WV0400X Optometrist, Vision Therapy (Licence: FL opc2575) | |
Enumeration Date | 2010-12-03 |
Last Update Date | 2012-02-06 |