| Dr Khaled Ibrahim, MD | |
|
264a Palm Coast Pkwy Ne, Palm Coast, FL 32137-8217 | |
| (386) 446-5505 | |
| Not Available |
| Full Name | Dr Khaled Ibrahim |
|---|---|
| Gender | Male |
| Speciality | General Practice |
| Experience | 32 Years |
| Location | 264a Palm Coast Pkwy Ne, Palm Coast, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497108393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 19420 (Puerto Rico) | Secondary |
| 208D00000X | General Practice | ACN1088 (Florida) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Roy H Hinman Md Pa | 3173584174 | 6 |
| Island Doctors Intrastate Llc | 5395161186 | 71 |
| Entity Name | Roy H Hinman Md Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649383845 PECOS PAC ID: 3173584174 Enrollment ID: O20041022000798 |
| Entity Name | Alina Community Center At Mount Dora Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811550346 PECOS PAC ID: 9032530829 Enrollment ID: O20200603001057 |
| Entity Name | Island Doctors Intrastate Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568083889 PECOS PAC ID: 5395161186 Enrollment ID: O20200811001733 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Khaled Ibrahim, MD 100 Arricola Ave, St Augustine, FL 32080-4515 Ph: (904) 825-4368 | Dr Khaled Ibrahim, MD 264a Palm Coast Pkwy Ne, Palm Coast, FL 32137-8217 Ph: (386) 446-5505 |
Dr. Rommelle Von Such, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 1 Florida Park Dr N, Suite 109-110, Palm Coast, FL 32137 Phone: 386-445-3619 Fax: 386-445-6925 | |
Dr. Lidya Margarita Lataban-lopez, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 20 Cypress Point Pkwy Ste A, Palm Coast, FL 32164 Phone: 386-586-7005 Fax: 844-867-3940 | |
Dr. Canice Chukwuocha, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 264a Palm Coast Pkwy Ne, Palm Coast, FL 32137 Phone: 386-446-5505 | |
Dr. Alex Ramon Taveras-cruz, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 264a Palm Coast Pkwy Ne, Palm Coast, FL 32137 Phone: 386-446-5505 Fax: 386-446-5077 | |
Santos Ramos Davila, MD General Practice Medicare: Not Enrolled in Medicare Practice Location: 2 Mccormick Dr, Palm Coast, FL 32164 Phone: 386-246-7365 |