Eye Site Vision Center III INC

NPI #1285936849 in Boca Raton, Florida

Provider Information

NPI Number: 1285936849
Entity Type: Organization
Organization Name: Eye Site Vision Center III INC
Primary Specialty: Optometrist
Enumeration Date: Dec 2, 2010
Last Updated: Feb 17, 2012

Practice Location

Address: 9874 YAMATO RD
Address 2: SUITE 120
City: Boca Raton
State: Florida
ZIP Code: 33434-5552
Phone: (561) 479-1411

Authorized Official

Name: DR. GARY E GOBERVILLE, OD
Title: PRES/OPTOMETRIST
Phone: (561) 479-1411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist - Pediatrics — Pediatrics	152WP0200X
Optometrist - Sports Vision — Sports Vision	152WS0006X
Optometrist - Vision Therapy — Vision Therapy	152WV0400X
Optometrist	152W00000X	Primary

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