| Doctor Name: | HASAN KHAN |
| NPI Number: | 1215270152 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | |
| Business Practice Address: | 1100 6nd Ave South St. Petersburg, FL - 337055620 |
| Business Phone Number: | 7278663166 |
| Business Fax Number: | 7278644043 |
| Mailing Address: | 10051 5th St. North, Suite 200 ST. PETERSBURG |
| State: | FL |
| Postal Code: | 337022211 |
| Phone Number: | 7278240780 |
| Fax Number: | 7275686011 |
| NPI Enumeration Date: | 03/28/2013 |
| NPI Last Update Date: | 05/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |