Organization
DAVENPORT PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA CRISTINA KHAN MD (CO-OWNER)
(863) 421-1855
Entity
Organization
Contact information
Practice address
103 PARK PLACE BLVD, DAVENPORT, FL 33837-6858
(863) 421-1855
(863) 421-2624
Mailing address
103 PARK PLACE BLVD, DAVENPORT, FL 33837-6858
(863) 421-1855
(863) 421-2624
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275150000
—
FL
Enumeration date
02/13/2007
Last updated
02/07/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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