Provider Demographics
NPI:1720196454
Name:HIRSCH, NATHAN BRUCE (MD)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:BRUCE
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 SW 62ND PL FL 3
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4800
Mailing Address - Country:US
Mailing Address - Phone:305-665-1133
Mailing Address - Fax:305-666-0258
Practice Address - Street 1:7300 SW 62ND PL
Practice Address - Street 2:3 FL
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4806
Practice Address - Country:US
Practice Address - Phone:305-665-1133
Practice Address - Fax:305-666-0258
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL54-2129332174400000X
FLME18044207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63371Medicare UPIN