Basic Information
| Provider Information | |||||||||
| NPI: | 1023234457 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZELIKOVSKY | ||||||||
| FirstName: | SHIRLEY | ||||||||
| MiddleName: | SHARONA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2600 WESTHALL LANE | ||||||||
| Address2: | BOX 300 | ||||||||
| City: | MAITLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072002300 | ||||||||
| FaxNumber: | 4072001353 | ||||||||
| Practice Location | |||||||||
| Address1: | 544 LEGACY PARK DR | ||||||||
| Address2: | |||||||||
| City: | CASSELBERRY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327072402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7726785723 | ||||||||
| FaxNumber: | 4076375772 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 05/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 78254 | GA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 50527 | KY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2007-01808 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 287936 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | ME100234 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207Q00000X | ME100234 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.