Individual
DR. MATHEEN AHMED KHUDDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4645 NW 8TH AVE, GAINESVILLE, FL 32605-4524
(352) 264-2500
(352) 331-9095
Mailing address
4645 NW 8TH AVE, GAINESVILLE, FL 32605-4524
(352) 264-2500
(352) 331-9095
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME88697
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME88697
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25319
BLUE CROSS FLORIDA
FL
05
—
281192800
—
FL
01
—
CM8550
MEDICARE RR
FL
Enumeration date
11/08/2006
Last updated
10/12/2017
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