Taher Khalil M D P a

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

ME81508 Issued in FL

Legal business name

TAHER KHALIL M D P A

Practice address

1425 Hand Ave
Suite K
Ormond Beach, FL 32174-1135

Phone

(386) 673-5404

Fax

(386) 673-5480

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Diana Borts

Title

Office Manager

Phone

(386) 673-5441

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Cardiovascular Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Taher Khalil, M D P A

  • Cardiovascular Disease Physician
  • Ormond Beach, FL
  • NPI 1821012113
  Medicare reassignment NPD

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1902829393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 HAND AVE",
            "address_2": "SUITE K",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741135",
            "telephone_number": "386-673-5404",
            "fax_number": "386-673-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 HAND AVE",
            "address_2": "SUITE K",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321741135",
            "telephone_number": "386-673-5404",
            "fax_number": "386-673-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHER KHALIL M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "BORTS",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-673-5441"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME81508",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": "ME81508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264363400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF FLORIDA",
            "identifier": "78667",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiovascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brittany Sweeting, SW
• Ronald P. Swendris, MD
• Garrett Sweringen, DPT
• Taylor Sweringen, PT, DPT
• Alexander Sy, PTA
• Tamara Pettit, LLC
• Tames Family Practice LLC
• Mardone Rivera Tan, PT
• Patrick Tank, PHARMD
• Jop Tannous

• Interventional Cardiology Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Interventional Cardiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.