# LIGHTHOUSE ORTHOPAEDIC ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801960174
- **Authorized official:** MR. THOMAS J GOBERVILLE MD (PRESIDENT)
- **Authorized official phone:** (954) 942-0321

## Contact information

- **Practice address:** 1821 NE 25 STREET, LIGHTHOUSE POINT, FL 33064-7744
- **Practice address phone:** (954) 942-0321
- **Practice address fax:** (954) 942-0432
- **Mailing address:** 1821 NE 25 STREET, LIGHTHOUSE POINT, FL 33064-7744
- **Mailing address phone:** (954) 942-0321
- **Mailing address fax:** (954) 946-7018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 38853 | FL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 08/22/2020