Hirtz, Susan Kathleen
Hirtz, Susan Kathleen is an sole proprietor health care provider with primary practice located at 5720 Crestview Dr , Lady Lake FL 32159-5925. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adult Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Hirtz, Susan Kathleen can be contacted via phone (352) 633-3060.Contact Information
Primary practice address
5720 Crestview Dr
Lady Lake FL 32159-5925
Phone: (352) 633-3060
Fax: (352) 633-3090
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | MD14264 | Oregon |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME0103996 | Florida |
Profile Details
| NPI number | 1417985623 |
|---|---|
| LBN Legal business name | Hirtz, Susan Kathleen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Nov 22nd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417985623 | NPPES |
| Oregon | Other | 1755 | SAIF |
| Oregon | MEDICAID | 117226 | SAIF |
| Oregon | Other | A156501 | SAIF |
| Oregon | Other | 033467000 | SAIF |
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