Provider Demographics
NPI:1699889220
Name:KHANNA, ASHOK K (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:K
Last Name:KHANNA
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 1:15493 STONEYBROOK WEST PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4769
Mailing Address - Country:US
Mailing Address - Phone:407-299-7791
Mailing Address - Fax:
Practice Address - Street 1:15493 STONEYBROOK WEST PKWY STE 110
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4769
Practice Address - Country:US
Practice Address - Phone:407-299-7791
Practice Address - Fax:407-299-7791
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48001207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL042998800Medicaid
FL53834Medicare ID - Type Unspecified
FLD15183Medicare UPIN