Organization
WEST FLORIDA MEDICAL ASSOCIATES, P. A
Active
Parent organization
WEST FLORIDA MEDICAL ASSOCIATES, P.A.
Other names
Comprehensive Primary Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST FLORIDA MEDICAL ASSOCIATES, P.A.
Authorized official
HASIBUL H. KHAN M.D. (PHYSICIAN/DIRECTOR)
(352) 503-2011
Entity
Organization
Contact information
Practice address
4363 SOUTH SUNCOAST BLVD, HOMOSASSA SPRINGS, FL 34446
(352) 503-2011
(352) 503-6892
Mailing address
3404 N. LECANTO HWY, SUITE C, BEVERLY HILLS, FL 34465
(352) 746-1558
(352) 746-3838
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
ME100419
FL
261QR1300X
Rural Health Clinic/Center
Primary
ME69230
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252639500
—
FL
05
—
378926800
—
FL
Enumeration date
08/13/2010
Last updated
04/10/2013
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