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NPI Code Detail

MEDICARE: DR. YOUSSEF KHALIL KHODOR DO

MEDICARE: DR. YOUSSEF KHALIL KHODOR DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOS8274FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151756OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437155017
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YOUSSEF KHALIL KHODOR DO
Provider Business Mailing Address
First Line : PO BOX 2066
Second Line :
City : LECANTO
State : FL
Zip : 34460-2066
Country : US
Telephone Number : 352-563-0931
Fax Number : 352-563-0935
Provider Business Practice Location Address
First Line : 1907 HIGHWAY 44 W
Second Line :
City : INVERNESS
State : FL
Zip : 34453-3801
Country : US
Telephone Number : 352-344-2273
Fax Number : 352-344-2204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 10/12/2021

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