Healthcare Provider Details

I. General information

NPI: 1093463119
Provider Name (Legal Business Name): XPRESS URGENT CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3889 MILITARY TRAIL SUITE 103
JUPITER FL
33458
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442
US

V. Phone/Fax

Practice location:
  • Phone: 561-468-2370
  • Fax: 561-566-1884
Mailing address:
  • Phone: 954-363-9582
  • Fax: 954-363-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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