Eye Site Vision Center Ii, INC

NPI #1720380389 in Lighthouse Point, Florida

Provider Information

NPI Number: 1720380389
Entity Type: Organization
Organization Name: Eye Site Vision Center Ii, INC
Primary Specialty: Optometrist
Enumeration Date: Dec 2, 2010
Last Updated: Feb 17, 2012

Practice Location

Address: 2490 N FEDERAL HWY
City: Lighthouse Point
State: Florida
ZIP Code: 33064-6812
Phone: (954) 943-3779

Authorized Official

Name: DR. GARY E GOBERVILLE, OD
Title: PRES/OPTOMETRIST
Phone: (954) 943-3779

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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