Provider Demographics
NPI:1952980062
Name:XSPURT PROVIDER SERVICES, INC.
Entity type:Organization
Organization Name:XSPURT PROVIDER SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:WASHINGTON-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-223-0386
Mailing Address - Street 1:6283 NW 201ST TER STE 2A
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2194
Mailing Address - Country:US
Mailing Address - Phone:786-863-4915
Mailing Address - Fax:305-624-7285
Practice Address - Street 1:6283 NW 201ST TER STE 2A
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2194
Practice Address - Country:US
Practice Address - Phone:786-223-0386
Practice Address - Fax:305-624-7285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care