Organization
MEDICAL & PSYCHIATRIC INSITIUTE OF FLORIDA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASAD KHAN MD (OWNER)
(304) 216-4000
Entity
Organization
Contact information
Practice address
6056 CENTRAL PARK BLVD, PORT ORANGE, FL 32127-9539
(304) 216-4000
(386) 676-2555
Mailing address
927 BEVILLE RD STE 7, SOUTH DAYTONA, FL 32119-1769
(386) 269-9009
(386) 269-9004
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
ME114528
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0116181000
—
WV
05
—
0206560
—
OH
Enumeration date
07/29/2013
Last updated
08/19/2014
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