Provider Demographics
NPI:1578554408
Name:HIRSCH, EDWARD DAVID (EDWARD HIRSCH MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:DAVID
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:EDWARD HIRSCH MD
Other - Prefix:
Other - First Name:EDWARD
Other - Middle Name:D
Other - Last Name:HIRSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDWARD HIRSCH MD, PA
Mailing Address - Street 1:3080 NW 99TH AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4038
Mailing Address - Country:US
Mailing Address - Phone:954-733-7606
Mailing Address - Fax:754-946-2066
Practice Address - Street 1:3080 NW 99TH AVE STE 304
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4038
Practice Address - Country:US
Practice Address - Phone:954-733-7606
Practice Address - Fax:754-946-2066
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80511207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263485600Medicaid
FL263485600Medicaid
FLE5887WMedicare PIN
FLE5887VMedicare PIN