Provider Demographics
NPI:1336700558
Name:KHALIFA, AMR (MD)
Entity Type:Individual
Prefix:
First Name:AMR
Middle Name:
Last Name:KHALIFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MEMORIAL MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-5980
Mailing Address - Country:US
Mailing Address - Phone:386-586-1580
Mailing Address - Fax:386-586-1563
Practice Address - Street 1:60 MEMORIAL MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-5980
Practice Address - Country:US
Practice Address - Phone:386-586-1580
Practice Address - Fax:386-586-1563
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME155453207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine