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General NPI Number Information
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NPI Number | 1174106892
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Entity Type | Individual
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Provider Name | HIMANSHU KRISHAN KHANNA MD
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Gender | Male
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Dates
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Enumeration Date | 04/30/2021
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 5717 RED BUG LAKE RD # 341
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4957
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Country | US
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Telephone | 321-207-0172
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Fax | 321-207-0175
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Provider Business Mailing Address
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Address Line | 175 W PINE AVE
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City | LONGWOOD
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State | FL
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Zip | 32750-4168
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Country | US
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Telephone | 321-207-0172
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Fax | 321-207-0175
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME169480
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License Number State | FL
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