Provider Demographics
NPI:1790836997
Name:AGHIGH, SOROUSH (MD)
Entity Type:Individual
Prefix:DR
First Name:SOROUSH
Middle Name:
Last Name:AGHIGH
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 1:19308 SW 77TH PL
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6248
Mailing Address - Country:US
Mailing Address - Phone:786-447-7415
Mailing Address - Fax:
Practice Address - Street 1:19308 SW 77TH PL
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6248
Practice Address - Country:US
Practice Address - Phone:786-447-7415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97298208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277412700Medicaid
FLME97298OtherMEDICAL LICENSE