Provider Demographics
NPI:1073044186
Name:DEEB, KHALED (MD, PHD, MBA)
Entity Type:Individual
Prefix:DR
First Name:KHALED
Middle Name:
Last Name:DEEB
Suffix:
Gender:M
Credentials:MD, PHD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6813 FINAMORE CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8727
Mailing Address - Country:US
Mailing Address - Phone:954-483-3381
Mailing Address - Fax:954-516-0720
Practice Address - Street 1:1010 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-1608
Practice Address - Country:US
Practice Address - Phone:954-483-3381
Practice Address - Fax:954-516-0720
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2023-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL141889207R00000X
FLME141889208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist