Provider Demographics
NPI:1134322167
Name:HIRA, NEERU (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NEERU
Middle Name:
Last Name:HIRA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 S.W. 60TH COURT
Mailing Address - Street 2:
Mailing Address - City:MIIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135
Mailing Address - Country:US
Mailing Address - Phone:305-669-6500
Mailing Address - Fax:
Practice Address - Street 1:3200 SW 60TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-4000
Practice Address - Country:US
Practice Address - Phone:305-669-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103124363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9103124OtherFLORIDA LICENSE