Healthcare Provider Details

I. General information

NPI: 1497093454
Provider Name (Legal Business Name): QUICKER CARE URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2013
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13770 BEACH BLVD. UNIT # 4
JACKSONVILLE FL
32224
US

IV. Provider business mailing address

13770 BEACH BLVD. UNIT # 4
JACKSONVILLE FL
32224
US

V. Phone/Fax

Practice location:
  • Phone: 904-330-0525
  • Fax: 904-647-9491
Mailing address:
  • Phone: 904-330-0525
  • Fax: 904-647-9491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberME99311
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ASHRAF ABU AFFAN
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 904-616-2772