Healthcare Provider Details

I. General information

NPI: 1730509670
Provider Name (Legal Business Name): JESSICA ELISABETH EICHLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA ELISABETH HENRY M.D.

II. Dates (important events)

Enumeration Date: 04/18/2014
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 NW 12TH ST
BOCA RATON FL
33432-2655
US

IV. Provider business mailing address

277 NW 12TH ST
BOCA RATON FL
33432-2655
US

V. Phone/Fax

Practice location:
  • Phone: 786-354-8783
  • Fax: 561-717-8084
Mailing address:
  • Phone: 561-735-2062
  • Fax: 561-717-8084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberME135801
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: