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General NPI Number Information
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NPI Number | 1356296503
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Entity Type | Organization
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Legal Business Name | INNOVA MEDICAL GROUP AND RESEARCH INC
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 5881 NW 151ST ST STE 201
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2442
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Country | US
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Telephone | 786-320-3460
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Fax |
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Provider Business Mailing Address
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Address Line | 5881 NW 151ST ST STE 201
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2442
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KHALIL AHMED KHAN
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Credential | DO
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Telephone | 786-320-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0001X
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Taxonomy Name | Clinical & Laboratory Immunology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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