Provider Demographics
NPI:1013952423
Name:KHILNANI, RESHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:RESHAM
Middle Name:
Last Name:KHILNANI
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:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34995-0417
Mailing Address - Country:US
Mailing Address - Phone:772-223-5665
Mailing Address - Fax:772-223-5646
Practice Address - Street 1:500 SE OSCEOLA ST
Practice Address - Street 2:STE 200
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2364
Practice Address - Country:US
Practice Address - Phone:772-286-1550
Practice Address - Fax:772-221-0569
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230399207R00000X
FLME98786207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278511100Medicaid
FL278511100Medicaid