| Organization Name: | EXPRESS CARE CLINIC LLC |
| NPI Number: | 1104247865 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | OLEKSANDR V ONUSHKO (PRESIDENT) |
| Mailing Address: | 2650 W State Road 434 Longwood |
| State: | FL US |
| Postal Code: | 327794815 |
| Phone Number: | 4074753366 |
| Fax Number: | 4074753367 |
| NPI Enumeration Date: | 12/26/2013 |
| NPI Last Update Date: | 10/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |