Healthcare Provider Details

I. General information

NPI: 1952264228
Provider Name (Legal Business Name): KHALIL SEMAJ MCPHERSON DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 11/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13777 BELTCHER RD S
LARGO FL
33771-4003
US

IV. Provider business mailing address

1616 SUNSET DR
TARPON SPRINGS FL
34689-2237
US

V. Phone/Fax

Practice location:
  • Phone: 727-532-1900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT43875
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: