Provider Demographics
NPI:1417108465
Name:HIRSCH, TALI
Entity Type:Individual
Prefix:MRS
First Name:TALI
Middle Name:
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18205 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 2214
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2106
Mailing Address - Country:US
Mailing Address - Phone:786-262-8222
Mailing Address - Fax:
Practice Address - Street 1:18205 BISCAYNE BLVD
Practice Address - Street 2:SUITE 2214
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2106
Practice Address - Country:US
Practice Address - Phone:786-262-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other