Healthcare Provider Details

I. General information

NPI: 1356170336
Provider Name (Legal Business Name): MAHER AL KHALDI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3609
US

IV. Provider business mailing address

2950 CLEVELAND CLINIC BLVD
WESTON FL
33331-3609
US

V. Phone/Fax

Practice location:
  • Phone: 954-659-5000
  • Fax: 954-659-5252
Mailing address:
  • Phone: 954-659-5000
  • Fax: 954-659-5252

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 Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberME173270
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: