Provider Demographics
NPI:1134414386
Name:KIRSCHBAUM, NEIL ISAAC (DO)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:ISAAC
Last Name:KIRSCHBAUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1951 SW 172ND AVE STE 314
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5614
Mailing Address - Country:US
Mailing Address - Phone:954-447-5206
Mailing Address - Fax:954-447-5259
Practice Address - Street 1:1951 SW 172ND AVE STE 314
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029
Practice Address - Country:US
Practice Address - Phone:954-447-5206
Practice Address - Fax:954-447-5259
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 133432081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine