MEDICARE: MARINA ADEL KHALIL APRN, FNP-C

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	207Q00000X	Family Medicine Physician	11040262	FL

General Provider Information

NPI Number	:	1720975055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARINA ADEL KHALIL APRN, FNP-C

Provider Business Mailing Address
First Line	:	1220 BUSINESS WAY STE 2
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-6073
Country	:	US
Telephone Number	:	239-303-2600
Fax Number	:	239-303-2604

Provider Business Practice Location Address
First Line	:	1220 BUSINESS WAY STE 2
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-6073
Country	:	US
Telephone Number	:	239-303-2600
Fax Number	:	239-303-2604

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

Provider Enumeration Date	:	06/19/2025
Last Update Date	:	01/12/2026

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