Provider Demographics
NPI:1346534948
Name:KHANIJOW, KAVITA D (MD)
Entity type:Individual
Prefix:
First Name:KAVITA
Middle Name:D
Last Name:KHANIJOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2202 DUCK SLOUGH BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5071
Mailing Address - Country:US
Mailing Address - Phone:727-203-5073
Mailing Address - Fax:727-205-4493
Practice Address - Street 1:2202 DUCK SLOUGH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5071
Practice Address - Country:US
Practice Address - Phone:727-203-5073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME136660207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN7668OtherHF MEDICARE