Provider Demographics
NPI:1861492043
Name:JOBE, NAUSHIN KHAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:NAUSHIN
Middle Name:KHAN
Last Name:JOBE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NAUSHIN
Other - Middle Name:SULTANA
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4789 COQUINA KEY DR SE
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-4812
Mailing Address - Country:US
Mailing Address - Phone:727-729-9009
Mailing Address - Fax:
Practice Address - Street 1:5901 SUN BLVD
Practice Address - Street 2:#113A
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33715-1166
Practice Address - Country:US
Practice Address - Phone:727-865-6941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93586208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL93046OtherBLUE CROSS