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General NPI Number Information
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NPI Number | 1639688286
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Entity Type | Individual
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Provider Name | YASER SOROSH KHALID DO
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Gender | Male
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 17786 SW 2ND ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-3923
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Country | US
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Telephone | 954-276-5552
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 810
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City | HANOVER
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State | NH
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Zip | 03755-0810
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Country | US
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Telephone | 603-308-1472
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | H0105134
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS16952
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | EL31855
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License Number State | NH
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