Provider Demographics
NPI:1356340723
Name:KHOUZAM, NAYER N (MD)
Entity type:Individual
Prefix:DR
First Name:NAYER
Middle Name:N
Last Name:KHOUZAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3802 OAKWATER CIR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6200
Mailing Address - Country:US
Mailing Address - Phone:407-650-0000
Mailing Address - Fax:407-650-8757
Practice Address - Street 1:3802 OAKWATER CIR
Practice Address - Street 2:SUITE 3
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6200
Practice Address - Country:US
Practice Address - Phone:407-650-0000
Practice Address - Fax:407-650-8757
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL48829208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375411100Medicaid
FLF59177Medicare UPIN
FLK1128Medicare PIN