Provider Demographics
NPI:1104705375
Name:HAMDAN, KHALID JAMAL (PA-C)
Entity type:Individual
Prefix:
First Name:KHALID
Middle Name:JAMAL
Last Name:HAMDAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAIN ST APT 216
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-8205
Mailing Address - Country:US
Mailing Address - Phone:305-788-1989
Mailing Address - Fax:
Practice Address - Street 1:1 MAIN ST APT 216
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-8205
Practice Address - Country:US
Practice Address - Phone:305-788-1989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant