# INNOVA MEDICAL GROUP AND RESEARCH INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356296503
- **Authorized official:** KHALIL AHMED KHAN DO (PRESIDENT)
- **Authorized official phone:** (786) 320-3460

## Contact information

- **Practice address:** 5881 NW 151ST ST STE 201, MIAMI LAKES, FL 33014-2442
- **Practice address phone:** (786) 320-3460
- **Mailing address:** 5881 NW 151ST ST STE 201, MIAMI LAKES, FL 33014-2442
- **Mailing address phone:** (786) 320-3460
- **Mailing address fax:** (305) 203-0729

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207NS0135X | Procedural Dermatology Physician | — | NULL | — |
| 207NS0135X | Procedural Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QD0401X | Diabetology (Family Medicine) Physician | — | NULL | — |
| 207QD0401X | Diabetology (Family Medicine) Physician | — | — | — |
| 207RI0001X | Clinical & Laboratory Immunology (Internal Medicine) Physician | — | NULL | — |
| 207RI0001X | Clinical & Laboratory Immunology (Internal Medicine) Physician | — | — | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QR1100X | Research Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/03/2026
- **Last updated:** 04/15/2026