Provider Demographics
NPI:1841566395
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:DR
Authorized Official - First Name:MAZIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIKARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
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:954-363-9663
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:XPRESS URGENT CARE, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-29
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008195600Medicaid