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General NPI Number Information
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NPI Number | 1902829393
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Entity Type | Organization
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Legal Business Name | TAHER KHALIL M D P A
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1425 HAND AVE SUITE K
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City | ORMOND BEACH
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State | FL
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Zip | 32174-1135
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Country | US
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Telephone | 386-673-5404
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Fax | 386-673-5480
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Provider Business Mailing Address
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Address Line | 1425 HAND AVE SUITE K
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City | ORMOND BEACH
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State | FL
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Zip | 32174-1135
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Country | US
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Telephone | 386-673-5404
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Fax | 386-673-5480
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DIANA BORTS
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Credential |
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Telephone | 386-673-5441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME81508
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME81508
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License Number State | FL
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