Healthcare Provider Details

I. General information

NPI: 1629555966
Provider Name (Legal Business Name): SOHAIL MOHAMMED SHARIFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/01/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 EAST AVE
WEST PALM BEACH FL
33407-2387
US

IV. Provider business mailing address

5300 EAST AVE
WEST PALM BEACH FL
33407-2387
US

V. Phone/Fax

Practice location:
  • Phone: 561-494-6887
  • Fax: 561-494-6889
Mailing address:
  • Phone: 561-494-6887
  • Fax: 561-494-6889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberME149997
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRL15074
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: