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General NPI Number Information
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NPI Number | 1457723215
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Entity Type | Organization
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Legal Business Name | MEDFLORIDA, LLC
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 3889 MILITARY TRL
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City | JUPITER
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State | FL
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Zip | 33458-2923
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Country | US
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Telephone | 561-932-0995
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Fax | 561-932-0997
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Provider Business Mailing Address
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Address Line | PO BOX 4189
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-4189
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Country | US
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Telephone | 954-363-9582
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Fax | 954-363-9663
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAZIN SHIKARA
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Credential | MD
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Telephone | 561-932-0995
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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