Individual
GEORGE KHOUDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10050 SW INNOVATION WAY, PORT ST LUCIE, FL 34987-2117
(772) 223-5945
(772) 345-5365
Mailing address
10050 SW INNOVATION WAY, PORT ST LUCIE, FL 34987-2117
(772) 223-5945
(772) 345-5365
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.131927
OH
207RG0100X
Gastroenterology Physician
Primary
ME168343
FL
Other
Enumeration date
06/24/2014
Last updated
07/01/2024
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