Provider Demographics
NPI:1497093454
Name:QUICKER CARE URGENT CARE
Entity Type:Organization
Organization Name:QUICKER CARE URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHRAF
Authorized Official - Middle Name:ABU
Authorized Official - Last Name:AFFAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-616-2772
Mailing Address - Street 1:13770 BEACH BLVD.
Mailing Address - Street 2:UNIT # 4
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224
Mailing Address - Country:US
Mailing Address - Phone:904-330-0525
Mailing Address - Fax:904-647-9491
Practice Address - Street 1:13770 BEACH BLVD.
Practice Address - Street 2:UNIT # 4
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224
Practice Address - Country:US
Practice Address - Phone:904-330-0525
Practice Address - Fax:904-647-9491
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGEL KIDS PEDIATRICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-27
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QU0200X
FLME99311305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL108479Medicaid
AL510I930612Medicare PIN