Healthcare Provider Details

I. General information

NPI: 1487160701
Provider Name (Legal Business Name): XPRESS URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2017
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3387 S JOG RD STE 103
GREENACRES FL
33467-2010
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442-4189
US

V. Phone/Fax

Practice location:
  • Phone: 561-781-8090
  • Fax: 561-781-8099
Mailing address:
  • Phone: 561-779-1652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MAZIN M SHIKARA
Title or Position: PRESIDENT
Credential: MD
Phone: 561-779-1652