MEDICARE: MR. HAROLD HIRSCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS10748	FL

General Provider Information

NPI Number	:	1174667711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. HAROLD HIRSCH

Provider Business Mailing Address
First Line	:	10000 W BAY HARBOR DR
Second Line	:	#425
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-1575
Country	:	US
Telephone Number	:	305-335-3499
Fax Number	:

Provider Business Practice Location Address
First Line	:	1777 NE 163RD ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4732
Country	:	US
Telephone Number	:	305-947-0433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	05/09/2008

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