Provider Demographics
NPI:1538139514
Name:MOSTAFAVI & SCHULICK MD PA
Entity Type:Organization
Organization Name:MOSTAFAVI & SCHULICK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:ARMAGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSTAFAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-736-8200
Mailing Address - Street 1:2800 S SEACREST BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435
Mailing Address - Country:US
Mailing Address - Phone:561-736-8200
Mailing Address - Fax:561-853-1608
Practice Address - Street 1:2800 S SEACREST BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435
Practice Address - Country:US
Practice Address - Phone:561-736-8200
Practice Address - Fax:561-853-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
94715OtherBCBS
94715OtherBCBS