Provider Demographics
NPI:1982246377
Name:HIRT, PENELOPE ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:PENELOPE
Middle Name:ALEXANDRA
Last Name:HIRT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20890 NE 31ST PL
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3638
Mailing Address - Country:US
Mailing Address - Phone:786-830-5866
Mailing Address - Fax:
Practice Address - Street 1:20890 NE 31ST PL
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3638
Practice Address - Country:US
Practice Address - Phone:786-830-5866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program