Provider Demographics
NPI:1033183652
Name:HIRZEL, LEON FRANCISCO III (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:FRANCISCO
Last Name:HIRZEL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SW 27TH AVE
Mailing Address - Street 2:SUITE 503
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-2961
Mailing Address - Country:US
Mailing Address - Phone:305-642-1401
Mailing Address - Fax:305-642-1403
Practice Address - Street 1:330 SW 27TH AVE
Practice Address - Street 2:SUITE 503
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2961
Practice Address - Country:US
Practice Address - Phone:305-642-1401
Practice Address - Fax:305-642-1403
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 40265208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068659000Medicaid
FL217613OtherAVMED
FL4257360OtherAETNA
FL96250OtherBLUE CROSS BLUE SHIELD
FL1023337OtherCAREPLUS
FL001080OtherNHP
FL4257360OtherAETNA
FL96250OtherBLUE CROSS BLUE SHIELD