Provider Demographics
NPI:1285615526
Name:KHAN, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1500 SAN REMO AVE
Mailing Address - Street 2:SUITE 285
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3043
Mailing Address - Country:US
Mailing Address - Phone:305-448-9018
Mailing Address - Fax:305-448-1895
Practice Address - Street 1:5000 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2008
Practice Address - Country:US
Practice Address - Phone:305-448-9018
Practice Address - Fax:305-448-1895
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0016097207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL91256OtherB/C & B/S OF FL
FLD59563Medicare UPIN
FL91256ZMedicare ID - Type Unspecified