Goberville, Gary E
Goberville, Gary E is an sole proprietor health care provider with primary practice located at 9804 S Military Trl Ste E7 , Boynton Beach FL 33436-3220. He recently has 4 registered licenses in different health care specialties including Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Goberville, Gary E can be contacted via phone (561) 738-5997.Contact Information
Primary practice address
9804 S Military Trl Ste E7
Boynton Beach FL 33436-3220
Phone: (561) 738-5997
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 2575 | Florida |
| Eye and Vision Services Providers / Sports Vision | 152WS0006X | 2575 | Florida |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 2575 | Florida |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC2575 | Florida |
Profile Details
| NPI number | 1346233780 |
|---|---|
| LBN Legal business name | Goberville, Gary E |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Sep 13th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346233780 | NPPES |
| Florida | MEDICAID | 078957700 |
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