| Medflorida, Llc | |
|
3889 Military Trl Jupiter FL 33458-2923 | |
| (561) 932-0995 | |
| (561) 932-0997 |
| Full Name | Medflorida, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3889 Military Trl, Jupiter, Florida |
| Authorized Official Name and Position | Mazin Shikara (PRESIDENT) |
| Authorized Official Contact | 5619320995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medflorida, Llc Po Box 69 Jupiter FL 33468-0069 Ph: (561) 932-0995 | Medflorida, Llc 3889 Military Trl Jupiter FL 33458-2923 Ph: (561) 932-0995 |
| NPI Number | 1457723215 |
|---|---|
| Provider Enumeration Date | 10/20/2015 |
| Last Update Date | 12/04/2017 |
| Medicare PECOS PAC ID | 8729347166 |
|---|---|
| Medicare Enrollment ID | O20180110003591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457723215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Yervant A Khatcherian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104823350 PECOS PAC ID: 0941499339 Enrollment ID: I20110118000143 |
| Provider Name | Dana Schnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780191551 PECOS PAC ID: 9032472634 Enrollment ID: I20180412002009 |
| Provider Name | Christine Lynne Holderman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518441278 PECOS PAC ID: 1153657184 Enrollment ID: I20190729000858 |
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