Healthcare Provider Details

I. General information

NPI: 1659730794
Provider Name (Legal Business Name): MEDICAL CONSULTANTS OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2016
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3889 MILITARY TRL 101
JUPITER FL
33458-2923
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442-4189
US

V. Phone/Fax

Practice location:
  • Phone: 561-932-0995
  • Fax:
Mailing address:
  • Phone: 561-932-0995
  • Fax: 561-932-0997

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 SHIKARA
Title or Position: PRESIDENT
Credential: MD
Phone: 561-932-0995