Healthcare Provider Details

I. General information

NPI: 1942449343
Provider Name (Legal Business Name): WILLIAM DAVID KIRSH DO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 BISCAYNE BLVD STE 211
NORTH MIAMI FL
33181-2735
US

IV. Provider business mailing address

12000 BISCAYNE BLVD SUITE 211
NORTH MIAMI FL
33181-2735
US

V. Phone/Fax

Practice location:
  • Phone: 305-534-9200
  • Fax: 305-534-0190
Mailing address:
  • Phone: 305-534-9200
  • Fax: 305-534-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM D KIRSH
Title or Position: PRESIDENT
Credential: DO
Phone: 305-534-9200