Healthcare Provider Details

I. General information

NPI: 1396023495
Provider Name (Legal Business Name): AMIT KHITHANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 09/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3641 S MIAMI AVE STE 331
MIAMI FL
33133
US

IV. Provider business mailing address

3641 S MIAMI AVE STE 331
MIAMI FL
33133-4204
US

V. Phone/Fax

Practice location:
  • Phone: 305-285-5092
  • Fax: 305-285-5093
Mailing address:
  • Phone: 305-285-5092
  • Fax: 305-285-5093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA150331
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME141830
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberA150331
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberME141830
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: