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General NPI Number Information
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NPI Number | 1568632453
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Entity Type | Organization
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Legal Business Name | NASIR KHALIDI & SAKINA KHALIDI, MD PA
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 2400 HARBOR BLVD SUITE 17
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5052
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Country | US
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Telephone | 941-629-3113
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Fax | 941-629-9764
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Provider Business Mailing Address
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Address Line | PO BOX 496420
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City | PORT CHARLOTTE
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State | FL
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Zip | 33949-6420
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Country | US
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Telephone | 941-629-3113
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Fax | 941-629-9764
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Authorized Official
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Title or Position | OWNER
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Name | SAKINA N KHALIDI
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Credential | M.D.
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Telephone | 941-629-3113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME32809
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License Number State | FL
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