Provider Demographics
NPI:1922075811
Name:EINHORN, NEIL MARTIN (OD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:MARTIN
Last Name:EINHORN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14080 SW 104TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-7063
Mailing Address - Country:US
Mailing Address - Phone:305-233-4262
Mailing Address - Fax:
Practice Address - Street 1:9885 SUNSET DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4617
Practice Address - Country:US
Practice Address - Phone:305-595-2020
Practice Address - Fax:305-595-2036
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1349152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T93930Medicare UPIN
FL19591Medicare ID - Type Unspecified