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General NPI Number Information
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NPI Number | 1487994091
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Entity Type | Organization
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Legal Business Name | SAIRA S. KHAN, M.D., P.A.
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Dates
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Enumeration Date | 02/18/2013
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Last Update Date | 02/18/2013
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Provider Practice Location Address
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Address Line | 303 N PLANT AVE SUITE 1
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City | PLANT CITY
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State | FL
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Zip | 33563-4730
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Country | US
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Telephone | 813-659-3328
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Fax | 813-659-3907
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Provider Business Mailing Address
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Address Line | 303 N PLANT AVE SUITE 1
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City | PLANT CITY
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State | FL
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Zip | 33563-4730
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Country | US
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Telephone | 813-659-3328
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Fax | 813-659-3907
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAIRA SADHIA KHAN
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Credential | M.D.
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Telephone | 813-659-3328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME72624
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License Number State | FL
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