Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | MD436126 | PA |
Y | 208800000X | Urologist | ME131348 | FL |
NPI | 1063643039 |
---|---|
Provider Name | Dr. Khaled Shahrour |
First Address | Zephyrhills, FL 33542-2511 |
Second Address | Zephyrhills, FL 33542-2511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2009 |
Last Update Date | 07/07/2021 |