MEDICARE: STEVEN P HIRSH DPM PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO0001789	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	87973	OTHER	FL	B/C B/S
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245472711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN P HIRSH DPM PA

Provider Business Mailing Address
First Line	:	4611 S UNIVERSITY DR
Second Line	:	SUITE 225
City	:	DAVIE
State	:	FL
Zip	:	33328-3817
Country	:	US
Telephone Number	:	954-434-6463
Fax Number	:	954-434-6463

Provider Business Practice Location Address
First Line	:	3332 GRIFFIN RD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-5519
Country	:	US
Telephone Number	:	954-924-6151
Fax Number	:	954-434-6463

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEVEN P HIRSH
Credential	:
Telephone Number	:	954-434-6463

Provider Enumeration Date	:	03/30/2009
Last Update Date	:	02/10/2010

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