Provider Demographics
NPI:1003833807
Name:HIRSCH, SANDRA LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LUZ
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:660 GLADES RD
Mailing Address - Street 2:STE 300
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431
Mailing Address - Country:US
Mailing Address - Phone:561-620-8992
Mailing Address - Fax:561-620-5815
Practice Address - Street 1:660 GLADES RD
Practice Address - Street 2:STE 300
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431
Practice Address - Country:US
Practice Address - Phone:561-620-8992
Practice Address - Fax:561-620-5815
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME71097207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL110185457OtherRAILROAD MEDICARE
FL2508692OtherGHI
FL31429OtherBLUE CROSS BLUE SHIELD OF FLA
G33513Medicare UPIN
FL31429AMedicare PIN