Provider Demographics
NPI:1841334174
Name:KHALAF, MAJID RAFIK (MD)
Entity type:Individual
Prefix:
First Name:MAJID
Middle Name:RAFIK
Last Name:KHALAF
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 1:1936 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2573
Mailing Address - Country:US
Mailing Address - Phone:772-778-8882
Mailing Address - Fax:772-778-8894
Practice Address - Street 1:1936 32ND AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2573
Practice Address - Country:US
Practice Address - Phone:772-778-8882
Practice Address - Fax:772-778-8894
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87468208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
U3904AOtherMEDICARE PTAN
U3904AOtherMEDICARE PTAN