Provider Demographics
NPI:1578100996
Name:AL KHOURY, ALEX AZIZ (MD)
Entity Type:Individual
Prefix:MR
First Name:ALEX AZIZ
Middle Name:
Last Name:AL KHOURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 NW 14TH ST. SUITE 1112
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-243-7596
Mailing Address - Fax:
Practice Address - Street 1:1120 NW 14TH ST. SUITE 1112
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-243-7596
Practice Address - Fax:305-689-1852
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME146582207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology