Provider Demographics
NPI:1851375489
Name:RIKABI, KHALED A (MD)
Entity Type:Individual
Prefix:DR
First Name:KHALED
Middle Name:A
Last Name:RIKABI
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 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6014
Mailing Address - Fax:
Practice Address - Street 1:1549 AIRPORT BLVD STE 430
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8634
Practice Address - Country:US
Practice Address - Phone:850-416-1817
Practice Address - Fax:850-416-1865
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD25396207RI0200X
MS15692207RI0200X
FLME143583207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03238237Medicaid
MS440000022Medicare ID - Type Unspecified
F05781Medicare UPIN