Healthcare Provider Details

I. General information

NPI: 1164855805
Provider Name (Legal Business Name): KHALED ABDELMAGID MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2013
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 W MILLER ST
ORLANDO FL
32806-2032
US

IV. Provider business mailing address

92 W MILLER ST
ORLANDO FL
32806-2032
US

V. Phone/Fax

Practice location:
  • Phone: 407-649-6907
  • Fax: 321-841-5245
Mailing address:
  • Phone: 407-649-6907
  • Fax: 321-841-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberME173574
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberME173574
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: