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Organization
MCM ACCOUNTABLE CARE ORGANIZATION LLC
Active
Organization
MCM ACCOUNTABLE CARE ORGANIZATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAZIN M SHIKARA M.D. (PRESIDENT/PHYSICIAN)
(561) 932-0995
Entity
Organization
Contact information
Practice address
600 HERITAGE DR, SUITE 105, JUPITER, FL 33458-3000
(561) 932-0995
(561) 932-0997
Mailing address
PO BOX 69, JUPITER, FL 33468-0069
(561) 932-0995
(561) 932-0997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME94252
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME94252
MEDICAL LICENSE
FL
Enumeration date
11/01/2012
Last updated
02/04/2013
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