Provider Demographics
NPI:1427236587
Name:TWIN LAKES MEDICAL CENTER LLC
Entity type:Organization
Organization Name:TWIN LAKES MEDICAL CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANVEER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-392-2021
Mailing Address - Street 1:2900 N MILITARY TRL
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6365
Mailing Address - Country:US
Mailing Address - Phone:561-392-2021
Mailing Address - Fax:561-394-4175
Practice Address - Street 1:2900 N MILITARY TRL
Practice Address - Street 2:SUITE 150
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6365
Practice Address - Country:US
Practice Address - Phone:561-392-2021
Practice Address - Fax:561-394-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAX957Medicare PIN