Healthcare Provider Details

I. General information

NPI: 1265061683
Provider Name (Legal Business Name): MUHAMMAD RIAZ KHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2020
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 SOUTHERN BLVD
WEST PALM BEACH FL
33406-3242
US

IV. Provider business mailing address

1620 SOUTHERN BLVD
WEST PALM BEACH FL
33406-3242
US

V. Phone/Fax

Practice location:
  • Phone: 610-864-0304
  • Fax: 716-631-9525
Mailing address:
  • Phone: 561-800-4111
  • Fax: 716-631-9525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME181226
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: