Provider Demographics
NPI:1205849379
Name:MEDEXPRESS URGENT CARE LLC
Entity Type:Organization
Organization Name:MEDEXPRESS URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MORANDI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:561-572-3200
Mailing Address - Street 1:1021 N STATE RD 7
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:561-333-9331
Mailing Address - Fax:561-792-2918
Practice Address - Street 1:1021 N STATE RD 7
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-333-9331
Practice Address - Fax:561-792-2918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC5468261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
G18765Medicare UPIN
FLK4397Medicare ID - Type Unspecified
FL6160770002Medicare NSC