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Individual
DR. GARY E GOBERVILLE
Active
Individual
DR. GARY E GOBERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2575
FL
152WP0200X
Pediatric Optometrist
2575
FL
152WS0006X
Sports Vision Optometrist
2575
FL
152WV0400X
Vision Therapy Optometrist
2575
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078957700
—
FL
Enumeration date
08/30/2005
Last updated
09/13/2024
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