MEDICARE: DR. ALEX GIBBERMAN O.D.

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	OPT.006280	OH

General Provider Information

NPI Number	:	1659785178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX GIBBERMAN O.D.

Provider Business Mailing Address
First Line	:	9553 FIELDS ERTEL RD
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-7320
Country	:	US
Telephone Number	:	513-428-2020
Fax Number	:	513-589-2020

Provider Business Practice Location Address
First Line	:	9553 FIELDS ERTEL RD
Second Line	:
City	:	LOVELAND
State	:	OH
Zip	:	45140-7320
Country	:	US
Telephone Number	:	513-428-2020
Fax Number	:	513-589-2020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2014
Last Update Date	:	03/26/2026

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