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General NPI Number Information
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NPI Number | 1295312403
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Entity Type | Individual
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Provider Name | AHRASH KHAJAEI DO
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Gender | Male
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 19735 US HIGHWAY 441 FL 2
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City | MOUNT DORA
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State | FL
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Zip | 32757-2204
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Country | US
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Telephone | 352-253-3251
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Fax | 352-755-9838
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Provider Business Mailing Address
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Address Line | 770 W GRANADA BLVD STE 101
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City | ORMOND BEACH
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State | FL
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Zip | 32174-5179
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Country | US
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Telephone |
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Fax | 352-755-9838
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | OS19969
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License Number State | FL
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