Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | CH8498 | FL |
NPI | 1538497144 |
---|---|
Provider Name | Dr. Lloyd H Gomberg |
First Address | Boca Raton, FL 33433-1143 |
Second Address | Boca Raton, FL 33432-6016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2009 |
Last Update Date | 21/09/2010 |