Individual
DR. PAUL EDWARD FUNDERBURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
6757 W NEWBERRY RD, GAINESVILLE, FL 32605-4312
(352) 331-2040
(352) 331-1526
Mailing address
6757 W NEWBERRY RD, GAINESVILLE, FL 32605-4312
(352) 331-2040
(352) 331-1526
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
591711900
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084871900
—
FL
01
—
1269
FLA LIC NUMBER
FL
01
—
591711900
TAX ID
—
Enumeration date
06/28/2006
Last updated
02/04/2011
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