Dr Azima Tariq Khan, MD | |
145 Miami Ave E, Venice, FL 34285-2407 | |
(941) 480-0088 | |
(941) 480-0006 |
Full Name | Dr Azima Tariq Khan |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 145 Miami Ave E, Venice, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912000175 | NPI | - | NPPES |
1235351412 | Other | GROUP NPI | |
1912000175 | Other | NPI | |
002939500 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ME86844 (Florida) | Primary |
Entity Name | Smh Physician Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346295292 PECOS PAC ID: 1355240177 Enrollment ID: O20031231000211 |
Mailing Address | Practice Location Address |
---|---|
Dr Azima Tariq Khan, MD Po Box 863407, Orlando, FL 32886-3407 Ph: (941) 917-2600 | Dr Azima Tariq Khan, MD 145 Miami Ave E, Venice, FL 34285-2407 Ph: (941) 480-0088 |
Dr. Keith B Johnson, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1370 E Venice Ave, Suite 202, Venice, FL 34285 Phone: 941-480-0500 Fax: 941-480-9322 | |
Ms. Susan Rucker Mihm, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 145 Miami Ave East, Venice, FL 34285 Phone: 941-480-0088 Fax: 941-480-0006 | |
Dr. Avanee Dhruv Master Lobo, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 145 Miami Ave E, Venice, FL 34285 Phone: 941-261-0088 Fax: 941-480-0006 | |
Mrs. Milagros M Seguerra-doctora, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 119 Shamrock Blvd, Venice, FL 34293 Phone: 941-493-3282 Fax: 941-493-1672 |