Provider Demographics
NPI:1922074830
Name:ALKHAFAJI, AZIZ A (MD)
Entity Type:Individual
Prefix:DR
First Name:AZIZ
Middle Name:A
Last Name:ALKHAFAJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR
Mailing Address - Street 2:STE 101
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-799-0046
Mailing Address - Fax:352-799-0115
Practice Address - Street 1:5411 GRAND BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4010
Practice Address - Country:US
Practice Address - Phone:727-342-3445
Practice Address - Fax:727-841-9141
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME00506102086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006611900Medicaid
FL04335OtherBCBS
FL046448100Medicaid
FL006611900Medicaid
FLD84780Medicare UPIN
FL04335WMedicare PIN
FL04335UMedicare PIN
FL04335OtherBCBS