Provider Demographics
NPI:1700372182
Name:KIRSCH DERMATOLOGY LLC
Entity Type:Organization
Organization Name:KIRSCH DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:267-901-2873
Mailing Address - Street 1:1012 GOODLETTE-FRANK RD N STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5463
Mailing Address - Country:US
Mailing Address - Phone:239-300-9767
Mailing Address - Fax:239-842-1273
Practice Address - Street 1:1012 GOODLETTE-FRANK RD N STE 100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5463
Practice Address - Country:US
Practice Address - Phone:239-300-9767
Practice Address - Fax:239-842-1273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty