Provider Demographics
NPI:1023234457
Name:ZELIKOVSKY, SHIRLEY SHARONA (MD)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:SHARONA
Last Name:ZELIKOVSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 WESTHALL LANE
Mailing Address - Street 2:BOX 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-200-2300
Mailing Address - Fax:407-200-1353
Practice Address - Street 1:544 LEGACY PARK DR
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-2402
Practice Address - Country:US
Practice Address - Phone:772-678-5723
Practice Address - Fax:407-637-5772
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA78254207Q00000X
KY50527207Q00000X
NC2007-01808207Q00000X
NY287936207Q00000X
FLME100234207R00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBX334VMedicare PIN