MEDICARE: SOHAIL A KHAN PA

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	363A00000X	Physician Assistant	PA 9102828	FL
2	208M00000X	Hospitalist Physician	PA9102828	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00407536	OTHER		RAILROAD MEDICARE

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
2	PA 9102828	OTHER	FL	PHYS ASSIST LICENSE

General Provider Information

NPI Number	:	1275745333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOHAIL A KHAN PA

Provider Business Mailing Address
First Line	:	10175 FORTUNE PKWY UNIT 1106
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6757
Country	:	US
Telephone Number	:	904-379-5928
Fax Number	:	904-379-5967

Provider Business Practice Location Address
First Line	:	10175 FORTUNE PKWY UNIT 1106
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-6757
Country	:	US
Telephone Number	:	904-379-5928
Fax Number	:	904-379-5967

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

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	04/16/2026

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Directions to “ SOHAIL A KHAN PA” Practice Location

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