MEDICARE: DR. SHARI LYNNE GOLDBERG OD

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	OPC2820	FL

General Provider Information

NPI Number	:	1841475407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARI LYNNE GOLDBERG OD

Provider Business Mailing Address
First Line	:	9272 NW 9TH COURT
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-6175
Country	:	US
Telephone Number	:	954-257-4294
Fax Number	:

Provider Business Practice Location Address
First Line	:	5976 CORAL RIDGE DRIVE
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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	01/02/2008

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