Provider Demographics
NPI:1306131875
Name:KHAN, MOHAMMED I (ARNP)
Entity type:Individual
Prefix:MR
First Name:MOHAMMED
Middle Name:I
Last Name:KHAN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4054
Mailing Address - Country:US
Mailing Address - Phone:321-295-3586
Mailing Address - Fax:407-891-0213
Practice Address - Street 1:3501 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4054
Practice Address - Country:US
Practice Address - Phone:321-295-3586
Practice Address - Fax:407-891-0213
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9259780363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health