Healthcare Provider Details

I. General information

NPI: 1710814959
Provider Name (Legal Business Name): MAHER KHALAF
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

4725 NEW BROAD ST APT 305
ORLANDO FL
32814-6429
US

V. Phone/Fax

Practice location:
  • Phone: 561-809-6862
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number158708
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: