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NPI Code Detail

MEDICARE: DR. PETER J EISENBERG MD

MEDICARE: DR. PETER J 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
12085R0202XDiagnostic Radiology PhysicianME66684FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21932155751OTHERFLNPI
325660OTHERFLBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932155751
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER J EISENBERG MD
Provider Business Mailing Address
First Line : 500 N HIATUS RD STE 200
Second Line :
City : PEMBROKE PINES
State : FL
Zip : 33026-5213
Country : US
Telephone Number : 954-437-4800
Fax Number : 954-437-6628
Provider Business Practice Location Address
First Line : 1901 SW 172ND AVE
Second Line :
City : MIRAMAR
State : FL
Zip : 33029-5592
Country : US
Telephone Number : 954-538-4864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 04/05/2022

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Directions to “ DR. PETER J EISENBERG MD” Practice Location

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