Provider Demographics
NPI:1982817763
Name:HIFT, EDGAR HANS JOSEF (MD)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:HANS JOSEF
Last Name:HIFT
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 1:3200 N OCEAN BLVD
Mailing Address - Street 2:2409
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-7152
Mailing Address - Country:US
Mailing Address - Phone:954-567-0637
Mailing Address - Fax:954-563-0416
Practice Address - Street 1:3200 N OCEAN BLVD
Practice Address - Street 2:2409
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-7152
Practice Address - Country:US
Practice Address - Phone:954-567-0637
Practice Address - Fax:954-563-0416
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0024688174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD51816Medicare UPIN