Provider Demographics
NPI:1407135239
Name:KHALAF, ANIS ANAS
Entity Type:Individual
Prefix:DR
First Name:ANIS
Middle Name:ANAS
Last Name:KHALAF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 533993
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32853-3993
Mailing Address - Country:US
Mailing Address - Phone:813-477-5555
Mailing Address - Fax:407-370-4488
Practice Address - Street 1:1900 N MILLS AVE STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1444
Practice Address - Country:US
Practice Address - Phone:407-370-4444
Practice Address - Fax:407-845-0000
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3010171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist