Provider Demographics
NPI:1871502666
Name:HIRSCH, BRETT SCOT (DO)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:SCOT
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1250 S TAMIAMI TRL
Mailing Address - Street 2:STE. 304
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2221
Mailing Address - Country:US
Mailing Address - Phone:941-365-2122
Mailing Address - Fax:941-365-2009
Practice Address - Street 1:1250 S TAMIAMI TRL
Practice Address - Street 2:SUITE 304
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2221
Practice Address - Country:US
Practice Address - Phone:941-365-2122
Practice Address - Fax:941-365-2009
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65-0707307OtherFEDERAL TAX I.D.