Provider Demographics
NPI:1922482892
Name:KHAN, AHMAD (MD)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:KHAN
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 1:9975 TAVISTOCK LAKES BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7665
Mailing Address - Country:US
Mailing Address - Phone:407-932-6193
Mailing Address - Fax:407-932-6194
Practice Address - Street 1:9975 TAVISTOCK LAKES BLVD STE 220
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7665
Practice Address - Country:US
Practice Address - Phone:407-932-6193
Practice Address - Fax:407-932-6194
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV28334207R00000X
FLME166380207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine