Individual
MR. TAREQ AL-KHATIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2852 TAMIAMI TRL, SUITE 5, PORT CHARLOTTE, FL 33952-5125
(941) 625-4442
(941) 625-9797
Mailing address
2852 TAMIAMI TRL, SUITE 5, PORT CHARLOTTE, FL 33952-5125
(941) 625-4442
(941) 625-9797
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-054967
IL
208600000X
Surgery Physician
Primary
ME0054121
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049600600
—
FL
Enumeration date
10/02/2007
Last updated
11/15/2018
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