Provider Demographics
NPI:1912116229
Name:HIRSCHBERG, MIRIAM (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:
Last Name:HIRSCHBERG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 UNIVERSITY BLVD N
Mailing Address - Street 2:MC-32
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5530
Mailing Address - Country:US
Mailing Address - Phone:904-253-2758
Mailing Address - Fax:904-253-1942
Practice Address - Street 1:515 W 6TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206-4324
Practice Address - Country:US
Practice Address - Phone:904-253-1264
Practice Address - Fax:904-253-1942
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1311582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily