Provider Demographics
NPI:1235346560
Name:SHAPIRO, ROBERTA GELBER
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:GELBER
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4530 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3005
Mailing Address - Country:US
Mailing Address - Phone:305-674-8158
Mailing Address - Fax:
Practice Address - Street 1:4530 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3005
Practice Address - Country:US
Practice Address - Phone:305-674-8158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00001771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ2887OtherBLUE CROSS
Z2887Medicare ID - Type Unspecified