Provider Demographics
NPI:1205030764
Name:MOHAN S KHURANA MD PA
Entity Type:Organization
Organization Name:MOHAN S KHURANA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAN
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-473-3303
Mailing Address - Street 1:1081 BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-2302
Mailing Address - Country:US
Mailing Address - Phone:941-473-3303
Mailing Address - Fax:
Practice Address - Street 1:130 S INDIANA AVE STE A
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-3301
Practice Address - Country:US
Practice Address - Phone:941-473-3303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27717207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty