NPIMap

Organization Active NPI

Medflorida, LLC

  • Internal Medicine Physician
  • Jupiter, FL
National Provider Identifier
1457723215
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDFLORIDA, LLC
Practice address
3889 Military TRL
Jupiter, FL 33458-2923
Phone
(561) 932-0995
Fax
(561) 932-0997
NPI assigned
Oct 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mazin Shikara, MDNPI 1316967912
Title
President
Phone
(561) 932-0995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

3889 Military TRL
Jupiter, FL 33458-2923

Mailing address

PO Box 4189
Deerfield Beach, FL 33442-4189
Phone (954) 363-9582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180110003591 FL Part B Supplier - Clinic/Group Practice 8729347166 Receives reassigned benefits from 3 practitioners
Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory

Locations

29605 US Highway 19 N
Ste 170
Clearwater, FL 33761
Phone (727) 771-8444

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1457723215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4189",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334424189",
            "telephone_number": "954-363-9582",
            "fax_number": "954-363-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3889 MILITARY TRL",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582923",
            "telephone_number": "561-932-0995",
            "fax_number": "561-932-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-20",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "SHIKARA",
        "authorized_official_first_name": "MAZIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-932-0995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.