Provider Demographics
NPI:1275689473
Name:KHAN, ZAKIR HASAN (MD)
Entity type:Individual
Prefix:
First Name:ZAKIR
Middle Name:HASAN
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 1:244 N CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-4212
Mailing Address - Country:US
Mailing Address - Phone:561-734-4535
Mailing Address - Fax:855-801-9757
Practice Address - Street 1:244 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-4212
Practice Address - Country:US
Practice Address - Phone:561-734-4535
Practice Address - Fax:855-801-9757
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40098207R00000X
FL40098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63117Medicare UPIN