MEDICARE: EXPRESS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center	ME71079	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073953584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS MD

Provider Business Mailing Address
First Line	:	6447 LAKE WORTH RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-3007
Country	:	US
Telephone Number	:	561-433-1700
Fax Number	:	561-642-7587

Provider Business Practice Location Address
First Line	:	6447 LAKE WORTH RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-3007
Country	:	US
Telephone Number	:	561-433-1700
Fax Number	:	561-642-7587

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. MOHAMMAD T JAVED
Credential	:	MD
Telephone Number	:	561-433-1700

Provider Enumeration Date	:	06/28/2013
Last Update Date	:	07/15/2013

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Directions to “EXPRESS MD ” Practice Location

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