Provider Demographics
NPI:1134551047
Name:HIRSCH, MATTHEW FREDERICK (PT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:FREDERICK
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 BIARRITZ DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1419
Mailing Address - Country:US
Mailing Address - Phone:912-713-0444
Mailing Address - Fax:
Practice Address - Street 1:3230 LAKE WORTH RD
Practice Address - Street 2:SUITE C
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3694
Practice Address - Country:US
Practice Address - Phone:561-968-7788
Practice Address - Fax:561-968-9969
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT011103225100000X
FLPT 28750225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist