Provider Demographics
NPI:1902915820
Name:KHATIB, ZIAD (MD)
Entity Type:Individual
Prefix:DR
First Name:ZIAD
Middle Name:
Last Name:KHATIB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5955 PONCE DE LEON BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146
Mailing Address - Country:US
Mailing Address - Phone:305-661-1515
Mailing Address - Fax:305-662-3723
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:NE WING, SUITE 121
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:305-662-8360
Practice Address - Fax:305-666-6387
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME00551102080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3730760-00Medicaid
FL23317 ZMedicare ID - Type Unspecified
FL3730760-00Medicaid