Eye Site Vision Center III Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2575 Issued in FL

Legal business name

EYE SITE VISION CENTER III INC

Practice address

9874 Yamato Rd
Suite 120
Boca Raton, FL 33434-5552

Phone

(561) 479-1411

Fax

(561) 479-4267

NPI assigned

Dec 2, 2010

Last updated

Feb 17, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gary E Goberville, OD

Title

Pres/Optometrist

Phone

(561) 479-1411

Specialties & licenses 4

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1285936849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9874 YAMATO RD",
            "address_2": "SUITE 120",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334345552",
            "telephone_number": "561-479-1411",
            "fax_number": "561-479-4267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9874 YAMATO RD",
            "address_2": "SUITE 120",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334345552",
            "telephone_number": "561-479-1411",
            "fax_number": "561-479-4267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SITE VISION CENTER III INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "GOBERVILLE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRES/OPTOMETRIST",
        "authorized_official_telephone_number": "561-479-1411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2575",
            "primary": true
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "FL",
            "license": "OPC2575",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "FL",
            "license": "OPC2575",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "FL",
            "license": "OPC2575",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.