Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | OS 0005077 | FL |
NPI | 1306836754 |
---|---|
Provider Name | William David Kirsh |
First Address | Miami, FL 33181-4234 |
Second Address | North Miami, FL 33181-2735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 30/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048174200 | (05) | FL |
E53978 | (02) |