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General NPI Number Information
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NPI Number | 1073953584
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Entity Type | Organization
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Legal Business Name | EXPRESS MD
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 6447 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33463-3007
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Country | US
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Telephone | 561-433-1700
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Fax | 561-642-7587
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Provider Business Mailing Address
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Address Line | 6447 LAKE WORTH RD
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City | LAKE WORTH
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State | FL
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Zip | 33463-3007
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Country | US
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Telephone | 561-433-1700
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Fax | 561-642-7587
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. MOHAMMAD T JAVED
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Credential | MD
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Telephone | 561-433-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | ME71079
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License Number State | FL
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