Express Care Clinic Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EXPRESS CARE CLINIC GROUP

Doing business as

Express Care Clinic Group

Practice address

2650 W State Road 434
Longwood, FL 32779-4815

Phone

(407) 475-3366

Fax

(407) 475-3367

NPI assigned

Sep 17, 2014

Last updated

Nov 12, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Oleksandr V Onushko

Title

President

Phone

(407) 475-3366

Specialties & licenses 2

Addresses

Other names 1

• Express Care Clinic Group Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1083016414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794815",
            "telephone_number": "407-475-3366",
            "fax_number": "407-475-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794815",
            "telephone_number": "407-475-3366",
            "fax_number": "407-475-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS CARE CLINIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "ONUSHKO",
        "authorized_official_first_name": "OLEKSANDR",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-475-3366"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Express Care Clinic Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Longwood, FL
• Providers in Longwood, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.