Provider Demographics
NPI:1528563814
Name:KHADR, ARIEL (HAS #AW5349)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:KHADR
Suffix:
Gender:F
Credentials:HAS #AW5349
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 SW 57TH AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5421
Mailing Address - Country:US
Mailing Address - Phone:305-661-7672
Mailing Address - Fax:
Practice Address - Street 1:7600 SW 57TH AVE STE 125
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5421
Practice Address - Country:US
Practice Address - Phone:305-661-7672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5349237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5349OtherHAS