Healthcare Provider Details

I. General information

NPI: 1396933198
Provider Name (Legal Business Name): MARC J HIRSH MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2007
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14610 S MILITARY TRL STE G3
DELRAY BEACH FL
33484-3801
US

IV. Provider business mailing address

14610 S MILITARY TRL STE G3
DELRAY BEACH FL
33484-3801
US

V. Phone/Fax

Practice location:
  • Phone: 561-819-3100
  • Fax: 561-819-3119
Mailing address:
  • Phone: 561-819-3100
  • Fax: 561-819-3119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number601184
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DR. MARC J. HIRSH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 561-819-3100