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General NPI Number Information
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NPI Number | 1568087526
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Entity Type | Organization
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Legal Business Name | FAST TRACK URGENT CARE LLC
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Dates
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Enumeration Date | 06/15/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 2400 NORTH BLVD W STE 1
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City | DAVENPORT
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State | FL
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Zip | 33837-8980
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Country | US
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Telephone | 402-720-4343
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Fax | 863-419-0025
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Provider Business Mailing Address
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Address Line | 2400 NORTH BLVD W STE 1
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City | DAVENPORT
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State | FL
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Zip | 33837-8980
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Country | US
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Telephone | 252-469-3352
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Fax | 863-419-0025
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | NAEEM Z AHMED
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Credential | MD
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Telephone | 402-720-4343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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