Individual
DR. RAFAY TARIQ KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
910 WILLISTON PARK PT STE 1000, LAKE MARY, FL 32746-2163
(407) 833-8028
(407) 833-8033
Mailing address
770 W GRANADA BLVD STE 101, ORMOND BEACH, FL 32174-5179
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
148112
CA
207RC0000X
Cardiovascular Disease Physician
TP719
KY
207RI0011X
Interventional Cardiology Physician
56767
KY
207RI0011X
Interventional Cardiology Physician
Primary
ME165341
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100824510
—
KY
Enumeration date
04/07/2017
Last updated
07/16/2025
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