MEDICARE: DR. MUFADDAL F KHEDA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	ME151225	FL
2	207RN0300X	Nephrology Physician	059860	GA
3	207R00000X	Internal Medicine Physician	1083734982	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	202I116355	OTHER	GA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083734982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUFADDAL F KHEDA MD

Provider Business Mailing Address
First Line	:	2783 NE 31ST CT
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-8545
Country	:	US
Telephone Number	:	706-414-2330
Fax Number	:

Provider Business Practice Location Address
First Line	:	2783 NE 31ST CT
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-8545
Country	:	US
Telephone Number	:	706-414-2330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/29/2025

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