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General NPI Number Information
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NPI Number | 1053620054
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Entity Type | Organization
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Legal Business Name | MUSHFEKA CONSULTING LLC
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Dates
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Enumeration Date | 09/25/2010
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 9442 BOCA RIVER CIR
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City | BOCA RATON
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State | FL
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Zip | 33434-3970
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Country | US
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Telephone | 561-852-4623
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Fax |
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Provider Business Mailing Address
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Address Line | 9442 BOCA RIVER CIR
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City | BOCA RATON
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State | FL
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Zip | 33434-3970
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MGR
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Name | MUSHFEKA M GOLAWALA
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Credential | M.D.
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Telephone | 561-852-4623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME103852
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License Number State | FL
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