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General NPI Number Information
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NPI Number | 1114421401
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Entity Type | Individual
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Provider Name | DR. JONATHAN D HIRSCHAUER
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Gender | Male
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 455 W WARREN AVE
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City | LONGWOOD
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State | FL
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Zip | 32750-4038
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Country | US
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Telephone | 407-262-2220
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Fax | 407-834-5011
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Provider Business Mailing Address
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Address Line | 455 W WARREN AVE
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City | LONGWOOD
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State | FL
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Zip | 32750-4038
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Country | US
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Telephone | 407-262-2220
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Fax | 407-834-5011
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | UO6290
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OS16470
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License Number State | FL
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