Provider Demographics
NPI:1316967912
Name:SHIKARA, MAZIN M (MD)
Entity type:Individual
Prefix:DR
First Name:MAZIN
Middle Name:M
Last Name:SHIKARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:954-363-9582
Mailing Address - Fax:954-363-9663
Practice Address - Street 1:3889 MILITARY TRL
Practice Address - Street 2:SUITE 101
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2923
Practice Address - Country:US
Practice Address - Phone:561-932-0995
Practice Address - Fax:561-932-0997
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94252207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME94252OtherMEDICAL LICENSE
FL007335300Medicaid
FLME94252OtherMEDICAL LICENSE
FLME94252OtherMEDICAL LICENSE