Healthcare Provider Details

I. General information

NPI: 1386664852
Provider Name (Legal Business Name): HIRAK J SEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/01/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 W BLOUNT ST
PENSACOLA FL
32501-2614
US

IV. Provider business mailing address

9904 HILLVIEW DR
PENSACOLA FL
32514-5701
US

V. Phone/Fax

Practice location:
  • Phone: 505-715-1598
  • Fax: 850-466-1784
Mailing address:
  • Phone: 505-715-1598
  • Fax: 850-476-9352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME152406
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number101724
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: