Provider Demographics
NPI:1235150996
Name:EISMAN & EISMAN MD PA
Entity Type:Organization
Organization Name:EISMAN & EISMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:EISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-932-7814
Mailing Address - Street 1:17971 BISCAYNE BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2532
Mailing Address - Country:US
Mailing Address - Phone:305-932-7814
Mailing Address - Fax:305-466-9051
Practice Address - Street 1:17971 BISCAYNE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:305-932-7814
Practice Address - Fax:305-466-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0015831207Q00000X
FLME0015832207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCK3012OtherRAILROAD MEDICARE
FL129800414874OtherHUMANA
FL1492299OtherCIGNA
FL00159OtherBLUE CROSS BLUE SHIELD
FL677143OtherUNITED HEALTH CARE
FL0007698322OtherAETNA
FL1492299OtherCIGNA