Healthcare Provider Details

I. General information

NPI: 1336497890
Provider Name (Legal Business Name): JOSEPH ANTHONY KHELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NW 95TH ST
MIAMI FL
33150-2038
US

IV. Provider business mailing address

6899 COLLINS AVE UNIT 1004N
MIAMI BEACH FL
33141-7402
US

V. Phone/Fax

Practice location:
  • Phone: 305-835-6191
  • Fax:
Mailing address:
  • Phone: 954-328-5509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberME124985
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301101663
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: