Individual
DR. KHALED IBRAHIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
264A PALM COAST PKWY NE, PALM COAST, FL 32137-8217
(386) 446-5505
Mailing address
100 ARRICOLA AVE, ST AUGUSTINE, FL 32080-4515
(904) 825-4368
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
19420
PR
208D00000X
General Practice Physician
Primary
ACN1088
FL
Other
Enumeration date
07/15/2016
Last updated
05/10/2023
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