Organization
TAHER KHALIL M D P A
Active
Other names
Cardiovascular Center
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA BORTS (OFFICE MANAGER)
(386) 673-5441
Entity
Organization
Contact information
Practice address
1425 HAND AVE, SUITE K, ORMOND BEACH, FL 32174-1135
(386) 673-5404
(386) 673-5480
Mailing address
1425 HAND AVE, SUITE K, ORMOND BEACH, FL 32174-1135
(386) 673-5404
(386) 673-5480
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME81508
FL
207RI0011X
Interventional Cardiology Physician
Primary
ME81508
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264363400
—
FL
01
—
78667
BC/BS OF FLORIDA
FL
Enumeration date
07/26/2006
Last updated
10/29/2024
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