Individual
MS. RACHA TONI KHALAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
501 6TH AVE SOUTH, ST. PETERSBURG, FL 33701
(727) 767-4106
(727) 767-8804
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
ME145357
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10664100
—
FL
01
—
MR239
MEDICARE
FL
01
—
V3NBM
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/23/2014
Last updated
10/27/2020
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