Provider Demographics
NPI:1346346459
Name:HIRZEL, LEON M (MD)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:M
Last Name:HIRZEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 226845
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33222-6845
Mailing Address - Country:US
Mailing Address - Phone:786-376-1632
Mailing Address - Fax:305-447-9470
Practice Address - Street 1:7951 SW 124TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-6051
Practice Address - Country:US
Practice Address - Phone:786-376-1632
Practice Address - Fax:305-447-9470
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME94724207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277828900Medicaid
FL09378OtherBCBS
FLME94724OtherSTATE MEDICAL LICENSE
FLME94724OtherSTATE MEDICAL LICENSE
FL277828900Medicaid