Provider Demographics
NPI:1154436798
Name:KHALEEL, AZEEAM S (PT)
Entity type:Individual
Prefix:
First Name:AZEEAM
Middle Name:S
Last Name:KHALEEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 CALABRIA WAY
Mailing Address - Street 2:
Mailing Address - City:HOWEY IN THE HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34737-0047
Mailing Address - Country:US
Mailing Address - Phone:407-844-7036
Mailing Address - Fax:
Practice Address - Street 1:721 CALABRIA WAY
Practice Address - Street 2:
Practice Address - City:HOWEY IN THE HILLS
Practice Address - State:FL
Practice Address - Zip Code:34737-0047
Practice Address - Country:US
Practice Address - Phone:407-844-7036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT194302251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical