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NPI Code Detail

MEDICARE: DR. ROGER K KHOURI MD

MEDICARE: DR. ROGER K KHOURI MD
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
12082S0105XSurgery of the Hand (Plastic Surgery) PhysicianME69615FL
22086S0122XPlastic and Reconstructive Surgery PhysicianME0069615FL
3174400000XSpecialistME69615FL

General Provider Information

NPI Number : 1740232784
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER K KHOURI MD
Provider Business Mailing Address
First Line : 2734 SW 37TH AVE
Second Line :
City : COCONUT GROVE
State : FL
Zip : 33133-2728
Country : US
Telephone Number : 305-642-4260
Fax Number : 305-426-3329
Provider Business Practice Location Address
First Line : 2734 SW 37TH AVE
Second Line :
City : COCONUT GROVE
State : FL
Zip : 33133-2728
Country : US
Telephone Number : 305-642-4260
Fax Number : 305-426-3329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 07/26/2022

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