Provider Demographics
NPI:1972097210
Name:AHMED KHAN, MAHJABEEN (MD)
Entity type:Individual
Prefix:DR
First Name:MAHJABEEN
Middle Name:
Last Name:AHMED KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 METROWEST BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3290
Mailing Address - Country:US
Mailing Address - Phone:321-842-6671
Mailing Address - Fax:321-843-6447
Practice Address - Street 1:6150 METROWEST BLVD STE 105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3290
Practice Address - Country:US
Practice Address - Phone:321-842-6671
Practice Address - Fax:321-843-6447
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018016195390200000X
FLME1696092084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program