Provider Demographics
NPI:1194039610
Name:KHAN, TANZEELA (MD)
Entity Type:Individual
Prefix:
First Name:TANZEELA
Middle Name:
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TANZEELA
Other - Middle Name:
Other - Last Name:YUMEEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:603 N FLAMINGO RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1023
Mailing Address - Country:US
Mailing Address - Phone:419-343-6076
Mailing Address - Fax:
Practice Address - Street 1:2400 N UNIVERSITY DR STE 215
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3629
Practice Address - Country:US
Practice Address - Phone:754-221-0456
Practice Address - Fax:754-221-0457
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 116720207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine