Healthcare Provider Details

I. General information

NPI: 1255262523
Provider Name (Legal Business Name): DR. FAHIM KHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 MAJOR BLVD STE 150
ORLANDO FL
32819-7971
US

IV. Provider business mailing address

1701 HIGHWAY A1A STE 300
VERO BEACH FL
32963-2263
US

V. Phone/Fax

Practice location:
  • Phone: 407-409-8118
  • Fax:
Mailing address:
  • Phone: 561-320-0996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME179844
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: