Provider Demographics
NPI:1487994091
Name:SAIRA S. KHAN, M.D., P.A.
Entity type:Organization
Organization Name:SAIRA S. KHAN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAIRA
Authorized Official - Middle Name:SADHIA
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-659-3328
Mailing Address - Street 1:303 N PLANT AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4730
Mailing Address - Country:US
Mailing Address - Phone:813-659-3328
Mailing Address - Fax:813-659-3907
Practice Address - Street 1:303 N PLANT AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4730
Practice Address - Country:US
Practice Address - Phone:813-659-3328
Practice Address - Fax:813-659-3907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72624261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care