Provider Demographics
NPI:1790278414
Name:SHARI L. GOLDBERG, O.D.,P.A.
Entity Type:Organization
Organization Name:SHARI L. GOLDBERG, O.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-257-4294
Mailing Address - Street 1:9272 NW 9TH CT
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6175
Mailing Address - Country:US
Mailing Address - Phone:954-257-4294
Mailing Address - Fax:
Practice Address - Street 1:2300 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069
Practice Address - Country:US
Practice Address - Phone:954-974-1973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty