Provider Demographics
NPI:1396933198
Name:MARC J HIRSH MD PA
Entity type:Organization
Organization Name:MARC J HIRSH MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:J
Authorized Official - Last Name:HIRSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-819-3100
Mailing Address - Street 1:14610 S MILITARY TRL STE G3
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-3801
Mailing Address - Country:US
Mailing Address - Phone:561-819-3100
Mailing Address - Fax:561-819-3119
Practice Address - Street 1:14610 S MILITARY TRL STE G3
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3801
Practice Address - Country:US
Practice Address - Phone:561-819-3100
Practice Address - Fax:561-819-3119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-07
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332900000X
FL601184207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAH349Medicare PIN
FLH18172Medicare UPIN