MEDICARE: XPRESS URGENT CARE, LLC.

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	208D00000X	General Practice Physician
2	261QU0200X	Urgent Care Clinic/Center

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	:	1497426829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	XPRESS URGENT CARE, LLC.

Provider Business Mailing Address
First Line	:	PO BOX 4189
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33442-4189
Country	:	US
Telephone Number	:	954-363-9582
Fax Number	:

Provider Business Practice Location Address
First Line	:	7229 W OAKLAND PARK BLVD STE 101
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-1004
Country	:	US
Telephone Number	:	954-824-2616
Fax Number	:	954-667-4007

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MAZIN M SHIKARA
Credential	:
Telephone Number	:	561-779-1652

Provider Enumeration Date	:	09/24/2021
Last Update Date	:	08/02/2023

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