Provider Demographics
NPI:1861577694
Name:KHAN, JAMIL H (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:H
Last Name:KHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1528 SUNRISE PLAZA DR
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-6205
Mailing Address - Country:US
Mailing Address - Phone:352-394-7728
Mailing Address - Fax:352-394-6369
Practice Address - Street 1:1528 SUNRISE PLAZA DR
Practice Address - Street 2:SUITE ONE
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-6205
Practice Address - Country:US
Practice Address - Phone:352-394-7728
Practice Address - Fax:352-394-6369
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2011-06-21
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Provider Licenses
StateLicense IDTaxonomies
FLME76198208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255361900Medicaid
FLG88799Medicare UPIN