Provider Demographics
NPI:1689096281
Name:KHATKAR, MANWANT (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MANWANT
Middle Name:
Last Name:KHATKAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5300 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4395
Mailing Address - Country:US
Mailing Address - Phone:954-725-4141
Mailing Address - Fax:954-725-4318
Practice Address - Street 1:5300 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4395
Practice Address - Country:US
Practice Address - Phone:954-725-4141
Practice Address - Fax:954-725-4318
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9106746363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical