MEDICARE: QUIK CLINIC MEDICAL CENTER

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	207V00000X	Obstetrics & Gynecology Physician	OS11490	FL
2	363LF0000X	Family Nurse Practitioner	2904542	FL
3	207R00000X	Internal Medicine Physician	ME81857	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DP610B	OTHER	FL	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1922320662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUIK CLINIC MEDICAL CENTER

Provider Business Mailing Address
First Line	:	PO BOX 14303
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33302-4303
Country	:	US
Telephone Number	:	954-530-9591
Fax Number	:	954-530-9597

Provider Business Practice Location Address
First Line	:	4055 N ANDREWS AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-5269
Country	:	US
Telephone Number	:	954-530-9591
Fax Number	:	954-530-9597

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIA FREEMAN
Credential	:
Telephone Number	:	954-530-9591

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	05/07/2019

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Directions to “QUIK CLINIC MEDICAL CENTER ” Practice Location

Language	Start Address	Practice Location

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