Provider Demographics
NPI:1871764431
Name:EDWARD D. HIRSCH MD PA
Entity type:Organization
Organization Name:EDWARD D. HIRSCH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-733-7606
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80511207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8887Medicare PIN