Healthcare Provider Details

I. General information

NPI: 1255969721
Provider Name (Legal Business Name): HIRAH SAQIB KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TAMPA EYE CLINIC 3000 W. DR. MARTIN LUTHER KING JR. BLVD
TAMPA FL
33607-6308
US

IV. Provider business mailing address

3000 W. DR. MARTIN LUTHER KING JR. BLVD
TAMPA FL
33607-6308
US

V. Phone/Fax

Practice location:
  • Phone: 813-877-2020
  • Fax: 813-872-7387
Mailing address:
  • Phone: 813-877-2020
  • Fax: 813-872-7387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number328481
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number328481
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberMF176629
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: