Healthcare Provider Details

I. General information

NPI: 1003042029
Provider Name (Legal Business Name): AFRASYAB KHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 06/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

AFRASYAB KHAN, HOUSE 97, STREET 2, K3, PHASE 3, HAYATABAD.
PESHAWAR NWFP
25000
PK

V. Phone/Fax

Practice location:
  • Phone: 352-265-0680
  • Fax:
Mailing address:
  • Phone: 0092915826827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberTRN13667
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: