Provider Demographics
NPI:1316268469
Name:JOSHI, HIREN JAGDISH (MD)
Entity type:Individual
Prefix:DR
First Name:HIREN
Middle Name:JAGDISH
Last Name:JOSHI
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 1:1845 JACLIF CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4430
Mailing Address - Country:US
Mailing Address - Phone:850-999-2328
Mailing Address - Fax:850-320-6114
Practice Address - Street 1:1845 JACLIF CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4430
Practice Address - Country:US
Practice Address - Phone:850-999-2328
Practice Address - Fax:850-320-6114
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113752207RN0300X
GA73317207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018559700Medicaid