Healthcare Provider Details

I. General information

NPI: 1427085869
Provider Name (Legal Business Name): JOHN HIRT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 SE FEDERAL HWY
HOBE SOUND FL
33455-5213
US

IV. Provider business mailing address

PO BOX 417
STUART FL
34995-0417
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-4943
  • Fax: 772-546-8345
Mailing address:
  • Phone: 772-223-5665
  • Fax: 772-223-5646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS7938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: