Provider Demographics
NPI:1275215915
Name:XPRESS URGENT CARE, LLC.
Entity Type:Organization
Organization Name:XPRESS URGENT CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAZIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHIKARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-779-1652
Mailing Address - Street 1:PO BOX 4189
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-4189
Mailing Address - Country:US
Mailing Address - Phone:954-363-9582
Mailing Address - Fax:954-363-9393
Practice Address - Street 1:3505 E HILLSBOROUGH AVE STE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-4547
Practice Address - Country:US
Practice Address - Phone:813-444-5577
Practice Address - Fax:813-424-5955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:XPRESS URGENT CARE, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008165619Medicaid