Individual provider Active NPI

Fazlah Lakhan

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1205785227
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11043956 Issued in FL
Practice address
3264 Greenwald Way N
Kissimmee, FL 34741-0728
Phone
(407) 539-0312
NPI assigned
Jan 23, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11043956 FL Primary

Addresses

Primary practice location

3264 Greenwald Way N
Kissimmee, FL 34741-0728

Mailing address

9500 NW 5TH St
Pembroke Pines, FL 33024-6215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260326003363 FL Practitioner - Nurse Practitioner 6305321449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

3264 Greenwald Way N
Kissimmee, FL 34741-0728
Phone (407) 539-0312

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11043956FLMDFamily Nurse Practitioner

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1769126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1205785227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 NW 5TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330246215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 GREENWALD WAY N",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347410728",
            "telephone_number": "407-539-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKHAN",
        "first_name": "FAZLAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-01-23",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11043956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.