Healthcare Provider Details

I. General information

NPI: 1619169810
Provider Name (Legal Business Name): MEDICAL CONSULTANTS OF FLORIDA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 W HILLSBORO BLVD STE 103
DEERFIELD BEACH FL
33442-1423
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442-4189
US

V. Phone/Fax

Practice location:
  • Phone: 954-408-8960
  • Fax: 954-408-8961
Mailing address:
  • Phone: 561-932-0995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 94252
License Number StateFL

VIII. Authorized Official

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