MEDICARE: KHIN NYEIN SU HLAING 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	207R00000X	Internal Medicine Physician	ME126705	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

General Provider Information

NPI Number	:	1831528892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHIN NYEIN SU HLAING MD

Provider Business Mailing Address
First Line	:	770 W GRANADA BLVD STE 101
Second Line	:
City	:	ORMOND BEACH
State	:	FL
Zip	:	32174-5179
Country	:	US
Telephone Number	:	386-231-4519
Fax Number	:	386-268-8927

Provider Business Practice Location Address
First Line	:	1055 SAXON BLVD
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-8468
Country	:	US
Telephone Number	:	386-917-7108
Fax Number	:	386-917-7293

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

Provider Enumeration Date	:	11/10/2013
Last Update Date	:	04/03/2026

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Directions to “ KHIN NYEIN SU HLAING MD” Practice Location

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