Provider Demographics
NPI:1174667711
Name:HIRSCH, HAROLD
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 W BAY HARBOR DR
Mailing Address - Street 2:#425
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-1575
Mailing Address - Country:US
Mailing Address - Phone:305-335-3499
Mailing Address - Fax:
Practice Address - Street 1:1777 NE 163RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-4732
Practice Address - Country:US
Practice Address - Phone:305-947-0433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS10748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist