Active NPI
Khaled Itani
- Psychiatry Physician
- Kissimmee, FL
National Provider Identifier
1285493759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- UO9631
- Practice address
- 720 West Oak Street, Suite 201
Kissimmee, FL 34741 - Phone
- (407) 518-2703
- NPI assigned
- Mar 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | UO9631 | FL | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
720 West Oak Street, Suite 201
Kissimmee, FL 34741
Mailing address
720 West Oak Street, Suite 201
Kissimmee, FL 34741
Phone (407) 518-2703
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- khaled.itani@hca4.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782777600000",
"number": "1285493759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 WEST OAK STREET, SUITE 201",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "34741",
"telephone_number": "407-518-2703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 WEST OAK STREET, SUITE 201",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "34741",
"telephone_number": "407-518-2703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITANI",
"first_name": "KHALED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-18",
"last_updated": "2026-06-30",
"certification_date": "2026-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "UO9631",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.