| Express Care Of Tampa Bay, Llc | |
|
6015 Rex Hall Ln Apollo Beach FL 33572-2657 | |
| (813) 641-0068 | |
| (813) 645-3816 |
| Full Name | Express Care Of Tampa Bay, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6015 Rex Hall Ln, Apollo Beach, Florida |
| Authorized Official Name and Position | Khawaja A Rahman (PRESIDENT) |
| Authorized Official Contact | 8136907589 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Express Care Of Tampa Bay, Llc 6015 Rex Hall Ln Apollo Beach FL 33572-2657 Ph: (813) 641-0068 | Express Care Of Tampa Bay, Llc 6015 Rex Hall Ln Apollo Beach FL 33572-2657 Ph: (813) 641-0068 |
| NPI Number | 1386700797 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 12/01/2011 |
| Medicare PECOS PAC ID | 4385629047 |
|---|---|
| Medicare Enrollment ID | O20040618000833 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386700797 | NPI | - | NPPES |
| 10560801 | Other | FL | CITRUS GROUP UC |
| 608813300 | Other | FL | DEPT OF LABOR FACILITY |
| B903U | Other | FL | BCBS GROUP UC |
| DB9962 | Other | FL | RR MCARE GROUP |
| 269227900 | Medicaid | FL |
| Provider Name | Abdus S Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538163969 PECOS PAC ID: 1456336114 Enrollment ID: I20040621001986 |
| Provider Name | Khawaja A Rahman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144298134 PECOS PAC ID: 0042201014 Enrollment ID: I20080826000044 |
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