Organization
KHADRA M OSMAN M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHADRA MOHAMOUD OSMAN M.D. (PRESIDENT)
(954) 832-0055
Entity
Organization
Contact information
Practice address
1625 SE 3RD AVE, SUITE 400, FORT LAUDERDALE, FL 33316-2521
(954) 832-0055
(954) 832-0262
Mailing address
1625 SE 3RD AVE, 400, FORT LAUDERDALE, FL 33316-2521
(954) 832-0055
(954) 832-0262
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME0060084
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370049600
—
FL
Enumeration date
01/25/2006
Last updated
08/29/2010
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