Medi-Fast Urgent Care, LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

MEDI-FAST URGENT CARE, LLC

Practice address

672 SW Prima Vista Blvd
Suite 102
Port St Lucie, FL 34983-1835

Phone

(561) 932-0995

Fax

(561) 932-0997

NPI assigned

Oct 14, 2011

Organization subpart

Yes

Parent organization

MEDICAL CONSULTANTS OF PALM BEACH, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Mazin M Shikara

Title

President

Phone

(561) 779-1652

Specialties & licenses 1

Addresses

Tax ID family

Concept Imaging LLC2 organizations share this tax ID, including this one

Part of

Medical Consultants of Palm

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Concept Imaging, LLC

  • Mobile Radiology Clinic/Center
  • Jupiter, FL
  • NPI 1306389317
  NPD tax ID

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1851676472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334680069",
            "telephone_number": "561-932-0995",
            "fax_number": "561-932-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 SW PRIMA VISTA BLVD",
            "address_2": "SUITE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831835",
            "telephone_number": "561-932-0995",
            "fax_number": "561-932-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI-FAST URGENT CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL CONSULTANTS OF PALM BEACH, LLC",
        "enumeration_date": "2011-10-14",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "SHIKARA",
        "authorized_official_first_name": "MAZIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-779-1652",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Kathleen McNamara, PMHNP
• Bonnie Amber McPherson
• MD-Prac LLC
• Med Braces and Supplies, LLC
• Medco Research Institute, L.L.C.
• Medic Warriors
• Medical Consultants of Florida LLC
• Medical Consultants of Florida, LLC
• Medical Risk Solutions
• Medical Solutions Consultants LLC

• Urgent Care Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.