Provider Demographics
NPI:1467545103
Name:KHAN, SAIRA SADHIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAIRA
Middle Name:SADHIA
Last Name:KHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N. PLANT AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563
Mailing Address - Country:US
Mailing Address - Phone:813-659-3328
Mailing Address - Fax:813-659-3907
Practice Address - Street 1:303 N. PLANT AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563
Practice Address - Country:US
Practice Address - Phone:813-659-3328
Practice Address - Fax:813-659-3907
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL72624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL080152095OtherMEDICARE RAILROAD
FL080152095OtherMEDICARE RAILROAD
FL49460Medicare ID - Type Unspecified
FL080152095OtherMEDICARE RAILROAD