MEDICARE: DR. ROBERT SCOTT SHAREK O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	18004473A	IN
2	152W00000X	Optometrist	OPC001798	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255445912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT SCOTT SHAREK O.D.

Provider Business Mailing Address
First Line	:	1108 NW 114TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-6309
Country	:	US
Telephone Number	:	954-856-8998
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 N STATE ROAD 7
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33313-1913
Country	:	US
Telephone Number	:	754-779-7951
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	04/03/2024

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