Provider Demographics
NPI:1184676926
Name:KHAN, RUMI AHMED (MD)
Entity Type:Individual
Prefix:DR
First Name:RUMI
Middle Name:AHMED
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AHMED
Other - Middle Name:J
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1222 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1215
Mailing Address - Country:US
Mailing Address - Phone:321-841-7856
Mailing Address - Fax:321-843-6432
Practice Address - Street 1:1222 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1215
Practice Address - Country:US
Practice Address - Phone:321-841-7856
Practice Address - Fax:321-843-6432
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME104891207RC0200X, 207RP1001X
WI48615207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME104891OtherMEDICAL LICENSE
FL001300700Medicaid
FL001300700Medicaid
I46056Medicare UPIN
WI093S 73-601Medicare PIN