Provider Demographics
NPI:1306836754
Name:KIRSH, WILLIAM DAVID (DO, MPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:KIRSH
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12000 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-4234
Mailing Address - Country:US
Mailing Address - Phone:305-534-9200
Mailing Address - Fax:305-534-0190
Practice Address - Street 1:12000 BISCAYNE BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2735
Practice Address - Country:US
Practice Address - Phone:305-534-9200
Practice Address - Fax:305-534-0190
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2016-09-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 0005077207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048174200Medicaid
E53978Medicare UPIN
FL048174200Medicaid