Basic Information
| Provider Information | |||||||||
| NPI: | 1578554408 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIRSCH | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | EDWARD HIRSCH MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | HIRSCH | ||||||||
| OtherFirstName: | EDWARD | ||||||||
| OtherMiddleName: | D. | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | EDWARD HIRSCH MD, PA | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7431 N UNIVERSITY DR | ||||||||
| Address2: | SUITE 211-A | ||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333212956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547337606 | ||||||||
| FaxNumber: | 9547337650 | ||||||||
| Practice Location | |||||||||
| Address1: | 7431 N UNIVERSITY DR | ||||||||
| Address2: | SUITE 211-A | ||||||||
| City: | TAMARAC | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333212956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547337606 | ||||||||
| FaxNumber: | 9547337650 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2005 | ||||||||
| LastUpdateDate: | 04/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | ME80511 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 263485600 | 05 | FL | MEDICAID |