Healthcare Provider Details

I. General information

NPI: 1205297389
Provider Name (Legal Business Name): MEDICAL CONSULTANTS OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2016
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21110 BISCAYNE BLVD STE 203
AVENTURA FL
33180-1251
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442-4189
US

V. Phone/Fax

Practice location:
  • Phone: 305-948-9595
  • Fax: 305-948-9292
Mailing address:
  • Phone: 305-948-9595
  • Fax: 305-948-9292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: MAZIN M SHIKARA
Title or Position: PRESIDENT
Credential:
Phone: 561-779-1652