Provider Demographics
NPI:1063087500
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:M
Authorized Official - Last Name:SHIKARA
Authorized Official - Suffix:
Authorized Official - Credentials:
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:561-781-8060
Mailing Address - Fax:561-781-8066
Practice Address - Street 1:4477 MEDICAL CENTER WAY STE A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3257
Practice Address - Country:US
Practice Address - Phone:561-781-8060
Practice Address - Fax:561-781-8066
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL CONSULTANTS OF FLORIDA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-26
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000236200Medicaid