Individual
SHYAMAZAN KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
1447 SW HERDER RD, PORT SAINT LUCIE, FL 34953-2269
(954) 552-3781
Mailing address
1447 SW HERDER RD, PORT SAINT LUCIE, FL 34953-2269
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11039521
FL
Other
Enumeration date
09/17/2025
Last updated
09/17/2025
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