Healthcare Provider Details

I. General information

NPI: 1811918709
Provider Name (Legal Business Name): CENTRAL FLORIDA INTERNISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 01/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3505 PROGRESS LN
SAINT CLOUD FL
34769-6519
US

IV. Provider business mailing address

3505 PROGRESS LN
SAINT CLOUD FL
34769-6519
US

V. Phone/Fax

Practice location:
  • Phone: 407-348-5175
  • Fax: 407-891-7819
Mailing address:
  • Phone: 407-348-5175
  • Fax: 407-891-7819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME85486
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME74021
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME88379
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP9176714
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP9200163
License Number StateFL
# 7
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNP9231147
License Number StateFL

VIII. Authorized Official

Name: MUHAMMAD A KHAN
Title or Position: CEO
Credential: M.D.
Phone: 407-343-5914