Provider Demographics
NPI:1033405774
Name:KHAN, NAREESHA (MD)
Entity Type:Individual
Prefix:
First Name:NAREESHA
Middle Name:
Last Name: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 1:7050 ULMERTON RD
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-5003
Mailing Address - Country:US
Mailing Address - Phone:727-777-4540
Mailing Address - Fax:305-698-6536
Practice Address - Street 1:855 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4446
Practice Address - Country:US
Practice Address - Phone:727-219-1833
Practice Address - Fax:305-698-6536
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119066207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine