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NPI Code Detail

MEDICARE: DR. IRIS EISENBERG MD

MEDICARE: DR. IRIS EISENBERG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080A0000XPediatric Adolescent Medicine PhysicianME32409FL

General Provider Information

NPI Number : 1326046350
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRIS EISENBERG MD
Provider Business Mailing Address
First Line : 11521 N MAIN ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-4002
Country : US
Telephone Number : 904-751-9491
Fax Number : 904-751-9492
Provider Business Practice Location Address
First Line : 11521 N MAIN ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32218-4002
Country : US
Telephone Number : 904-751-9491
Fax Number : 904-751-9492
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 03/07/2023

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