Provider Demographics
NPI:1578855060
Name:JAMES E HIRSCH DC PA
Entity type:Organization
Organization Name:JAMES E HIRSCH DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-322-4155
Mailing Address - Street 1:900 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-4236
Mailing Address - Country:US
Mailing Address - Phone:407-322-4155
Mailing Address - Fax:407-322-4151
Practice Address - Street 1:900 W 25TH ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-4236
Practice Address - Country:US
Practice Address - Phone:407-322-4155
Practice Address - Fax:407-322-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEV799AOtherMEDICARE PTAN
FL380872600Medicaid
FLT56318Medicare UPIN