Healthcare Provider Details

I. General information

NPI: 1841566395
Provider Name (Legal Business Name): XPRESS URGENT CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2012
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 SW PRIMA VISTA BLVD SUITE 102
PORT ST LUCIE FL
34983-1835
US

IV. Provider business mailing address

PO BOX 4189
DEERFIELD BEACH FL
33442-4189
US

V. Phone/Fax

Practice location:
  • Phone: 561-932-0995
  • Fax: 561-932-0997
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: DR. MAZIN SHIKARA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-779-1652