Provider Demographics
NPI:1851653539
Name:EISELER, SARA ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ROSE
Last Name:EISELER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 DRYDEN RD # 5.70
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2400
Mailing Address - Country:US
Mailing Address - Phone:517-281-1949
Mailing Address - Fax:
Practice Address - Street 1:410 S 11TH ST
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4256
Practice Address - Country:US
Practice Address - Phone:863-676-1433
Practice Address - Fax:941-676-9323
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10043087207R00000X
OK34688207R00000X
FLME123060208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist