Provider Demographics
NPI:1568488740
Name:DELFANI, SOHAIL (MD)
Entity Type:Individual
Prefix:DR
First Name:SOHAIL
Middle Name:
Last Name:DELFANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 SW 99TH AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4667
Mailing Address - Country:US
Mailing Address - Phone:305-596-6150
Mailing Address - Fax:305-596-6154
Practice Address - Street 1:7100 SW 99TH AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4667
Practice Address - Country:US
Practice Address - Phone:305-596-6150
Practice Address - Fax:305-596-6154
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87991207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004117400Medicaid
FLME87991OtherSTATE MEDICAL LICENSE
FLH94608Medicare UPIN
FL004117400Medicaid