Provider Demographics
NPI:1225562762
Name:KHER, PRAVEEN K (DO)
Entity Type:Individual
Prefix:DR
First Name:PRAVEEN
Middle Name:K
Last Name:KHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 SE 2ND ST APT 904
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-4177
Mailing Address - Country:US
Mailing Address - Phone:908-229-8053
Mailing Address - Fax:
Practice Address - Street 1:220 SE 2ND ST APT 904
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-4177
Practice Address - Country:US
Practice Address - Phone:908-229-8053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308694207P00000X
390200000X
FL19338207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program