Provider Demographics
NPI:1811929615
Name:HIRIART, JAVIER ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:ALBERTO
Last Name:HIRIART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 198054
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8054
Mailing Address - Country:US
Mailing Address - Phone:786-467-3140
Mailing Address - Fax:
Practice Address - Street 1:15955 SW 96TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1272
Practice Address - Country:US
Practice Address - Phone:786-467-3140
Practice Address - Fax:786-533-9276
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 787422080A0000X
FLME78742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259222300Medicaid
FL259222300Medicaid
FLH26896Medicare UPIN