MEDICARE: SHARI L GOLDBERG O D P A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OP 2820	FL

General Provider Information

NPI Number	:	1538328455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARI L GOLDBERG O D P A

Provider Business Mailing Address
First Line	:	5976 CORAL RIDGE DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3302
Country	:	US
Telephone Number	:	954-227-2148
Fax Number	:	954-227-7488

Provider Business Practice Location Address
First Line	:	5976 CORAL RIDGE DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3302
Country	:	US
Telephone Number	:	954-227-2148
Fax Number	:	954-227-7488

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SHARI L. GOLDBERG
Credential	:	OD
Telephone Number	:	954-257-4294

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	12/11/2008

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