Provider Demographics
NPI:1568445187
Name:SHORROCK, ROBIN GELLER (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:GELLER
Last Name:SHORROCK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-5322
Mailing Address - Country:US
Mailing Address - Phone:954-786-1030
Mailing Address - Fax:954-786-8282
Practice Address - Street 1:211 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-5322
Practice Address - Country:US
Practice Address - Phone:954-786-1030
Practice Address - Fax:954-786-8282
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLC1864152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277230OtherAV MED
FL20584OtherBLUE CROSS BLUE SHIELD
FL114740OtherAETNA
FL277230OtherAV MED
FLT547774Medicare UPIN
FL20584OtherBLUE CROSS BLUE SHIELD