Provider Demographics
NPI:1679050983
Name:KHALAF, MAHER AHMAD (ARNP)
Entity Type:Individual
Prefix:MR
First Name:MAHER
Middle Name:AHMAD
Last Name:KHALAF
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4696
Mailing Address - Country:US
Mailing Address - Phone:813-615-8088
Mailing Address - Fax:813-596-6164
Practice Address - Street 1:3000 MEDICAL PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4696
Practice Address - Country:US
Practice Address - Phone:813-615-8088
Practice Address - Fax:813-596-6164
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9401020363LG0600X
FL9401020363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health