Provider Demographics
NPI:1225560816
Name:KHAN, KAMRAN (MD)
Entity type:Individual
Prefix:DR
First Name:KAMRAN
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 ENTERPRISE CTR STE 109
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3760
Mailing Address - Country:US
Mailing Address - Phone:516-724-4080
Mailing Address - Fax:516-724-4080
Practice Address - Street 1:10151 ENTERPRISE CTR STE 109
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3760
Practice Address - Country:US
Practice Address - Phone:516-724-4080
Practice Address - Fax:516-724-4080
Is Sole Proprietor?:No
Enumeration Date:2017-04-01
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1645332086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery