MEDICARE: KHALDIA TAUFIQ KHALED

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	308164	LA
2	207R00000X	Internal Medicine Physician	ME173439	FL
3	207RC0000X	Cardiovascular Disease Physician	308164	LA
4	207RC0000X	Cardiovascular Disease Physician	ME173439	FL
5	207RI0011X	Interventional Cardiology Physician	308164	LA
6	207RI0011X	Interventional Cardiology Physician	ME173439	FL

General Provider Information

NPI Number	:	1952796302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALDIA TAUFIQ KHALED

Provider Business Mailing Address
First Line	:	13127 VAIL RIDGE DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-7196
Country	:	US
Telephone Number	:	813-661-6199
Fax Number	:	813-661-6334

Provider Business Practice Location Address
First Line	:	13127 VAIL RIDGE DR
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33579-7196
Country	:	US
Telephone Number	:	813-661-6199
Fax Number	:	813-661-6334

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

Provider Enumeration Date	:	04/02/2015
Last Update Date	:	07/02/2025

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Directions to “ KHALDIA TAUFIQ KHALED ” Practice Location

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