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: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 W MILLER ST
ORLANDO FL
32806-2032
US

IV. Provider business mailing address

1700 CENTER ST CWEB 1, RM 1538
MOBILE AL
36688-0001
US

V. Phone/Fax

Practice location:
  • Phone: 407-649-6907
  • Fax: 321-841-5245
Mailing address:
  • Phone: 251-434-3915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberME173574
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: