Provider Demographics
NPI:1003811647
Name:SHECTER, ROBIN ILANA (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:ILANA
Last Name:SHECTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:ILANA
Other - Last Name:GOLDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5808 S JOG RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6511
Mailing Address - Country:US
Mailing Address - Phone:561-968-7546
Mailing Address - Fax:561-968-1143
Practice Address - Street 1:5808 S JOG RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6511
Practice Address - Country:US
Practice Address - Phone:561-968-7546
Practice Address - Fax:561-968-1143
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7628207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH03252Medicare UPIN
FL46977WMedicare ID - Type Unspecified