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Organization

EXPRESS CARE OF TAMPA BAY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KHAWAJA A RAHMAN MD (PRESIDENT)
(813) 690-7589
Entity
Organization

Contact information

Practice address
6015 REX HALL LN, APOLLO BEACH, FL 33572-2657
(813) 641-0068
(813) 645-3816
Mailing address
6015 REX HALL LN, APOLLO BEACH, FL 33572-2657
(813) 641-0068
(813) 645-3816

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME0071027
FL
207R00000X
Internal Medicine Physician
Primary
ME0079013
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME71027
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME79013
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10560801
CITRUS GROUP UC
FL
05
269227900
FL
01
608813300
DEPT OF LABOR FACILITY
FL
01
B903U
BCBS GROUP UC
FL
01
DB9962
RR MCARE GROUP
FL
Enumeration date
12/29/2006
Last updated
12/01/2011
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