Organization
EYE SITE VISION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY E GOBERVILLE OD (PRES/OPTOMETRIST)
(954) 344-3937
Entity
Organization
Contact information
Practice address
2344 N UNIVERSITY DR, CORAL SPRINGS, FL 33065-5122
(954) 344-3937
(954) 344-2434
Mailing address
2344 N UNIVERSITY DR, CORAL SPRINGS, FL 33065-5122
(954) 344-3937
(954) 344-2434
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2575
FL
152WP0200X
Pediatric Optometrist
OPC2575
FM
152WS0006X
Sports Vision Optometrist
OPC2575
FL
152WV0400X
Vision Therapy Optometrist
OPC2575
FL
Other
Enumeration date
12/03/2010
Last updated
02/06/2012
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