MEDICARE: DIVIS K KHAIRA M.D.

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	207R00000X	Internal Medicine Physician	2014-00861	NC
2	207RH0003X	Hematology & Oncology Physician	319482	NY
3	207RH0003X	Hematology & Oncology Physician	ME172684	FL
4	207RH0003X	Hematology & Oncology Physician	M-2097	GU
5	207RH0003X	Hematology & Oncology Physician	2014-00861	NC
6	207RH0003X	Hematology & Oncology Physician	MD60789499	WA
7	207RH0003X	Hematology & Oncology Physician	2648	WI
8	208M00000X	Hospitalist Physician	ME172684	FL

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285637298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIVIS K KHAIRA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 100224
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32610-0278
Country	:	US
Telephone Number	:	352-273-7832
Fax Number	:

Provider Business Practice Location Address
First Line	:	8931 COLONIAL CENTER DR STE 300
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33905-7809
Country	:	US
Telephone Number	:	239-343-9567
Fax Number	:	239-343-9571

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	05/11/2026

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Directions to “ DIVIS K KHAIRA M.D.” Practice Location

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