| Entity Name: | MCM ACCOUNTABLE CARE ORGANIZATION, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Jun 2012 (13 years ago) |
| Document Number: | L12000076598 |
| FEI/EIN Number | 455470056 |
| Mail Address: | PO BOX 4189, Deerfield Beach, FL, 33442, US |
| Address: | 1950 W Hillsboro Blvd, Deerfield Beach, FL, 33442, US |
| ZIP code: | 33442 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881948677 | 2012-11-01 | 2013-02-04 | PO BOX 69, JUPITER, FL, 334680069, US | 600 HERITAGE DR, SUITE 105, JUPITER, FL, 334583000, US | |||||||||||||||||||||||||
|
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| Phone | +1 561-932-0995 |
| Fax | 5619320997 |
Authorized person
| Name | MAZIN M SHIKARA |
| Role | PRESIDENT/PHYSICIAN |
| Phone | 5619320995 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | ME94252 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAL LICENSE |
| Number | ME94252 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHIKARA MAZIN M | Agent | 1950 W Hillsboro Blvd, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| SHIKARA MAZIN M | Managing Member | 1950 W Hillsboro Blvd, Deerfield Beach, FL, 33442 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-21 | 1950 W Hillsboro Blvd, Ste 201, Deerfield Beach, FL 33442 | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-21 | 1950 W Hillsboro Blvd, Ste 201, Deerfield Beach, FL 33442 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-01-21 | 1950 W Hillsboro Blvd, Ste 201, Deerfield Beach, FL 33442 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-01-21 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-06-22 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-07 |
| ANNUAL REPORT | 2017-04-23 |
| ANNUAL REPORT | 2016-04-30 |
| ANNUAL REPORT | 2015-05-01 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
