Provider Demographics
NPI:1639484835
Name:ROBIN GELLER SHORROCK OD PA
Entity Type:Organization
Organization Name:ROBIN GELLER SHORROCK OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:GELLER
Authorized Official - Last Name:SHORROCK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-786-1030
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1864152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicare PIN