Provider Demographics
NPI:1861467557
Name:KHAN, SABIHA (MD)
Entity Type:Individual
Prefix:
First Name:SABIHA
Middle Name:
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 1:201 NW 82ND AVE
Mailing Address - Street 2:#201
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7808
Mailing Address - Country:US
Mailing Address - Phone:954-236-3232
Mailing Address - Fax:954-236-3236
Practice Address - Street 1:201 NW 82ND AVE
Practice Address - Street 2:#201
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7808
Practice Address - Country:US
Practice Address - Phone:954-236-3232
Practice Address - Fax:954-236-3236
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0068920207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL191529OtherHEALTHEASE
FLME0068920OtherFL LIC. NUMBER
FL024118OtherNHP
FL378828800Medicaid
FL5636073OtherAETNA
FL2367OtherCBCA / ONESOURCE EPO
FL27686OtherBCBS
FL27686OtherBCBS
FL378828800Medicaid
FLBK4574617OtherDEA NUMBER
FL65-0604701OtherTAX ID NUMBER