Basic Information
| Provider Information | |||||||||
| NPI: | 1497959886 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KHAN | ||||||||
| FirstName: | KASHAN | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31810 U.S. HIGHWAY 27 | ||||||||
| Address2: | P M PEDIATRICS, P.A. | ||||||||
| City: | HAINES CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8634191428 | ||||||||
| FaxNumber: | 8634221893 | ||||||||
| Practice Location | |||||||||
| Address1: | 327 WEST CYPRESS STREET | ||||||||
| Address2: | PM PEDIATRICS, P.A. | ||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4074830672 | ||||||||
| FaxNumber: | 4073485882 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2007 | ||||||||
| LastUpdateDate: | 05/24/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | ME-100789 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine |
No ID Information.