Provider Demographics
NPI:1265537781
Name:HIRSCH, ANNE L (LM)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:L
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 ALCAZAR WAY S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-4604
Mailing Address - Country:US
Mailing Address - Phone:727-452-6188
Mailing Address - Fax:727-491-5462
Practice Address - Street 1:1010 ALCAZAR WAY S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705
Practice Address - Country:US
Practice Address - Phone:727-452-6188
Practice Address - Fax:727-491-5462
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW143176B00000X
WAMW60245603176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340233900Medicaid