Provider Demographics
NPI:1609927631
Name:DR LUIS B EIBER PA
Entity Type:Organization
Organization Name:DR LUIS B EIBER PA
Other - Org Name:HIALEAH FOOT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:EIBER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-558-7437
Mailing Address - Street 1:4410 WEST 16TH AVENUE # 53
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-7194
Mailing Address - Country:US
Mailing Address - Phone:305-558-7437
Mailing Address - Fax:
Practice Address - Street 1:7150 W 20TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5509
Practice Address - Country:US
Practice Address - Phone:305-558-7437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO001534213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390348600Medicaid
FL0906870002Medicare NSC
FL21180Medicare ID - Type Unspecified
FLU02610Medicare UPIN