Provider Demographics
NPI:1720301021
Name:KHALIL, MONA (AP)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:KHALIL
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10737 S PRESERVE WAY APT 208
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6557
Mailing Address - Country:US
Mailing Address - Phone:561-843-1644
Mailing Address - Fax:
Practice Address - Street 1:10737 S PRESERVE WAY APT 208
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-6557
Practice Address - Country:US
Practice Address - Phone:561-843-1644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2754171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist