Provider Demographics
NPI:1851676472
Name:MEDI-FAST URGENT CARE, LLC
Entity Type:Organization
Organization Name:MEDI-FAST URGENT CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
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 69
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-0069
Mailing Address - Country:US
Mailing Address - Phone:561-932-0995
Mailing Address - Fax:561-932-0997
Practice Address - Street 1:672 SW PRIMA VISTA BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1835
Practice Address - Country:US
Practice Address - Phone:561-932-0995
Practice Address - Fax:561-932-0997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL CONSULTANTS OF PALM BEACH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-14
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care