Healthcare Provider Details

I. General information

NPI: 1932964772
Provider Name (Legal Business Name): SARA KHWAJA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 SIMEON DR
PALM HARBOR FL
34683-6254
US

IV. Provider business mailing address

2080 SIMEON DR
PALM HARBOR FL
34683-6254
US

V. Phone/Fax

Practice location:
  • Phone: 727-401-4030
  • Fax:
Mailing address:
  • Phone: 727-401-4030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberHSE38987
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberHSE38987
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberHSE38987
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: