Khaled Mohammed Al-Farawi, MD
Individual provider Active NPI Pediatrics Physician · Panama City, FL
NPI 1669887139 · NPPES record last updated Feb 25, 2025
Key facts
- NPI
- 1669887139
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- ME131759 (FL)
- Practice address
- 528 W Baldwin Rd
Panama City, FL 32405-3313 - Phone
- (850) 522-1522
- Fax
- (850) 522-5925
- NPI assigned
- Jun 24, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 13
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180313000547 | FL | Practitioner - Pediatric Medicine |
2567681430 | Reassigns benefits to 3 organizations |
| I20240304000608 | TX | Practitioner - Pediatric Medicine |
2567681430 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U5058 | TX | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Medicine Services of TX, PLLC | Current |
Accepting new patients | |
| Holmes County Hospital Corp | Current |
Accepting new patients | |
| The Pathology Group of Northwest Florida PLLC | Current | Accepting new patients | |
| Clear Lake Pediatric Clinic, P.a. | Pediatrics | Current |
Accepting new patients |
| Vivid Pathology PA | Current | Accepting new patients | |
| Holmes County Hospital Corp | Current |
Accepting new patients | |
| Northwest Florida Healthcare, Inc | Current |
Accepting new patients | |
| Precious Pearls Pediatrics LLC | Pediatrics | Current |
Accepting new patients |
| Emergency Medicine Services of FL, LLC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Medicine Services of TX, PLLC | Emergency Medicine | Current |
Accepting new patients |
| Northwest Florida Healthcare, Inc | Current |
Accepting new patients | |
| Centre for Integrative and Holistic Medicine | Past |
Accepting new patients | |
| Chca Clear Lake LP | Past | Accepting new patients |
Locations
101 E Wisconsin Ave
Bonifay, FL 32425
Phone (850) 547-2209
2600 Hospital Dr
Bonifay, FL 32425
Phone (850) 416-6484
322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858
1360 Brickyard Rd
Chipley, FL 32428
Phone (850) 415-8300
14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929
20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290
105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953
2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426
12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444
11455 Fallbrook Dr
Ste 202
Houston, TX 77065
Phone (281) 890-7475
11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000
7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564
26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700
500 W Medical Center Blvd
Webster, TX 77598
Phone (713) 447-4650
16 Professional Park Dr
Webster, TX 77598
Phone (281) 332-3503
Interoperability endpoints
- khaled.al-farawi.1@14612.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | U5058 | TX | |
| Pediatrics Physician | 208000000X | ME131759 | FL | Yes |
Addresses
Primary practice location
528 W Baldwin Rd
Panama City, FL 32405-3313
Mailing address
PO Box 15775
Panama City, FL 32406-5775
Phone (304) 521-5337
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020590600 | Medicaid | FL |
Other providers in Panama City, FL
- Anthony L Aker
- Jannette C Aker
- Mary Lou Akin
- Rush Emmett Akin Sr.
- Danielle K Akins
- Mohammad Nouri Al-Nahhas
- Lindsay Devane Albanese
- Albert F Mapp Jr M D P a
- Cassidi Leanne Albert-Smith
- Daisy Alberto
All providers in Panama City, FL · Pediatrics Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.