Provider Demographics
NPI:1366801334
Name:MEDICAL CONSULTANTS OF FLORIDA LLC
Entity type:Organization
Organization Name:MEDICAL CONSULTANTS OF FLORIDA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAZIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIKARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-779-1652
Mailing Address - Street 1:PO BOX 4189
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-4189
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1485 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8313
Practice Address - Country:US
Practice Address - Phone:561-572-3227
Practice Address - Fax:561-572-3228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000236200Medicaid
FLAK534Medicare UPIN