Provider Demographics
NPI:1518309434
Name:EXPRESS DOCS, LLC
Entity Type:Organization
Organization Name:EXPRESS DOCS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGMR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MUSOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-702-4541
Mailing Address - Street 1:14530 S MILITARY TRL
Mailing Address - Street 2:STE A1-5
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-3706
Mailing Address - Country:US
Mailing Address - Phone:561-381-0260
Mailing Address - Fax:
Practice Address - Street 1:14530 S MILITARY TRL
Practice Address - Street 2:STE A1-5
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3706
Practice Address - Country:US
Practice Address - Phone:561-381-0260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10723261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009708400Medicaid
FL009708400Medicaid