Individual provider Active NPI

Shaly Robince, APRN

  • Family Nurse Practitioner
  • Lauderdale Lakes, FL
National Provider Identifier
1255980066
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11003707 Issued in FL
Practice address
4850 W Oakland Park Blvd Ste 115
Lauderdale Lakes, FL 33313-7268
Phone
(954) 486-8663
Fax
(954) 486-8979
NPI assigned
Sep 5, 2019
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11003707 FL Primary

Addresses

Primary practice location

4850 W Oakland Park Blvd Ste 115
Lauderdale Lakes, FL 33313-7268

Mailing address

4850 W Oakland Park Blvd Ste 115
Lauderdale Lakes, FL 33313-7268
Phone (954) 486-8663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200916002164 FL Practitioner - Nurse Practitioner 9638597099 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shaly Robince IncGroup PAC ID 2567994072, 2 clinicians

Practice addresses (Care Compare)

4850 W Oakland Park Blvd
Suite 115
Lauderdale Lakes, FL 33313-7268
Phone (954) 486-8663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11003707FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Aug 1, 2020 Accepting new patients
South Broward Hospital District CurrentSince Aug 1, 2020 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Oct 1, 2020 Accepting new patients
Aslam M Khan MD PA PastSince Sep 1, 2019 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

3501 Johnson St
Fl 1
Hollywood, FL 33021
Phone (954) 265-7750

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1255980066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 115",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137268",
            "telephone_number": "954-486-8663",
            "fax_number": "954-486-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 115",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137268",
            "telephone_number": "954-486-8663",
            "fax_number": "954-486-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINCE",
        "first_name": "SHALY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.