Provider Demographics
NPI:1003042029
Name:KHAN, AFRASYAB
Entity type:Individual
Prefix:
First Name:AFRASYAB
Middle Name:
Last Name:KHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AFRASYAB KHAN, HOUSE 97, STREET 2, K3,
Mailing Address - Street 2:PHASE 3, HAYATABAD.
Mailing Address - City:PESHAWAR
Mailing Address - State:NWFP
Mailing Address - Zip Code:25000
Mailing Address - Country:PK
Mailing Address - Phone:009291-582-6827
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-0680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN13667208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLTRN13667OtherTRN NUMBER