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Individual

DR. MARK E. GOLDBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2929 N UNIVERSITY DR, SUITE 106, CORAL SPRINGS, FL 33065-5081
(954) 752-9570
(954) 752-9660
Mailing address
2929 N UNIVERSITY DR, SUITE 106, CORAL SPRINGS, FL 33065-5081
(954) 752-9570
(954) 752-9660

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 1084
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1134450001
PALMETTO SUPPLIER NUMBER
FL
Enumeration date
05/20/2006
Last updated
01/03/2011
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