Provider Demographics
NPI:1053629832
Name:EISENMAN, DONALD M (AP)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:M
Last Name:EISENMAN
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 MICHIGAN AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-3323
Mailing Address - Country:US
Mailing Address - Phone:305-812-6779
Mailing Address - Fax:
Practice Address - Street 1:1536 MICHIGAN AVE
Practice Address - Street 2:APT 3
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-3323
Practice Address - Country:US
Practice Address - Phone:305-812-6779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2881171100000X
FLMA40831172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No172M00000XOther Service ProvidersMechanotherapist