MEDICARE: ANESS AL-KHATEEB 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	2018-01753	NC
2	208M00000X	Hospitalist Physician	2018-01753	NC

General Provider Information

NPI Number	:	1972983765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANESS AL-KHATEEB MD

Provider Business Mailing Address
First Line	:	5534 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-2817
Country	:	US
Telephone Number	:	941-757-2100
Fax Number	:	941-757-2101

Provider Business Practice Location Address
First Line	:	5534 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-2817
Country	:	US
Telephone Number	:	941-757-2100
Fax Number	:	941-757-2101

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

Provider Enumeration Date	:	06/05/2015
Last Update Date	:	06/26/2025

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