| Entity Name: | MEDFLORIDA HOSPITALISTS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 11 Oct 2016 (8 years ago) |
| Document Number: | L16000187676 |
| FEI/EIN Number | 81-4245010 |
| Mail Address: | P.O. BOX 4189, Deerfield Beach, FL, 33442, US |
| Address: | 1950 W Hillsboro Blvd, Ste 201, 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 | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1144763772 | 2016-11-30 | 2024-07-10 | PO BOX 4189, DEERFIELD BEACH, FL, 334424189, US | 3889 MILITARY TRL STE 104, JUPITER, FL, 334582923, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-363-9582 |
| Fax | 9643639663 |
| Phone | +1 561-406-6080 |
| Fax | 5614066073 |
Authorized person
| Name | MAZIN SHIKARA |
| Role | CEO |
| Phone | 5617791652 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | ME94252 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019598200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SHIKARA FAMILY Limited Liability Limited P | Agent | 1950 W Hillsboro Blvd, Deerfield Beach, FL, 33442 |
| Name | Role | Address |
|---|---|---|
| SHIKARA FAMILY Limited Liability Limited P | 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 |
| REGISTERED AGENT NAME CHANGED | 2017-04-23 | SHIKARA FAMILY Limited Liability Limited Partnership | 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 |
| Florida Limited Liability | 2016-10-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
