Individual
DR. AZIMA TARIQ KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
145 MIAMI AVE E, VENICE, FL 34285-2407
(941) 480-0088
(941) 480-0006
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME86844
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002939500
—
FL
01
—
1235351412
GROUP NPI
—
01
—
1912000175
NPI
—
Enumeration date
09/06/2006
Last updated
08/09/2019
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