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 1:260 CRANDON BLVD STE 32-187
Mailing Address - Street 2:
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-1536
Mailing Address - Country:US
Mailing Address - Phone:305-366-1114
Mailing Address - Fax:305-365-1119
Practice Address - Street 1:260 CRANDON BLVD STE 8
Practice Address - Street 2:
Practice Address - City:KEY BISCAYNE
Practice Address - State:FL
Practice Address - Zip Code:33149-1537
Practice Address - Country:US
Practice Address - Phone:305-366-1114
Practice Address - Fax:305-365-1119
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2024-10-08
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
FLME97298OtherMEDICAL LICENSE
FLME97298OtherMEDICAL LICENSE