| Entity Name: | QUICKER CARE URGENT CARE, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 23 Jan 2013 (12 years ago) |
| Document Number: | L13000011697 |
| FEI/EIN Number | 90-0924898 |
| Address: | 13770 BEACH BOULEVARD, SUITE 4, JACKSONVILLE, FL, 32224, US |
| Mail Address: | 13770 BEACH BOULEVARD, SUITE 4, JACKSONVILLE, FL, 32224, US |
| ZIP code: | 32224 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497093454 | 2013-01-27 | 2014-03-28 | 13770 BEACH BLVD., UNIT # 4, JACKSONVILLE, FL, 32224, US | 13770 BEACH BLVD., UNIT # 4, JACKSONVILLE, FL, 32224, US | |||||||||||||||||||||||||||||
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| Phone | +1 904-330-0525 |
| Fax | 9046479491 |
Authorized person
| Name | MR. ASHRAF ABU AFFAN |
| Role | MEDICAL DOCTOR |
| Phone | 9046162772 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 305S00000X - Point of Service |
| License Number | ME99311 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 108479 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| Affan Ashraf | Agent | 4160 Boulevard Center Drive, Jacksonville, FL, 32207 |
| Name | Role |
|---|---|
| ANGEL KIDS, P.A. | Auth |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000033626 | PRIME LAB | EXPIRED | 2013-04-08 | 2018-12-31 | No data | 13770 BEACH BOULEVARD, SUITE 4, JACKSONVILLE, FL, 32224 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2021-05-27 | Affan, Ashraf | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-05-27 | 4160 Boulevard Center Drive, Jacksonville, FL 32207 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-07 |
| ANNUAL REPORT | 2023-04-12 |
| ANNUAL REPORT | 2022-03-31 |
| AMENDED ANNUAL REPORT | 2021-05-27 |
| ANNUAL REPORT | 2021-03-25 |
| ANNUAL REPORT | 2020-04-30 |
| ANNUAL REPORT | 2019-03-26 |
| ANNUAL REPORT | 2018-03-17 |
| ANNUAL REPORT | 2017-04-02 |
| ANNUAL REPORT | 2016-04-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
