Provider Demographics
NPI:1952369233
Name:KHAN, ZAHEER A (MD)
Entity Type:Individual
Prefix:DR
First Name:ZAHEER
Middle Name:A
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:Z
Other - Middle Name:A
Other - Last Name:KHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:205 N PLANT AVE
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4731
Mailing Address - Country:US
Mailing Address - Phone:813-754-1871
Mailing Address - Fax:813-754-1872
Practice Address - Street 1:205 N PLANT AVE
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4731
Practice Address - Country:US
Practice Address - Phone:813-754-1871
Practice Address - Fax:813-754-1872
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0019906207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL069462200Medicaid
FL069462200Medicaid
FL29717Medicare PIN