Healthcare Provider Details

I. General information

NPI: 1568546471
Provider Name (Legal Business Name): BRUCE N EISENBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 ARTHUR GODFREY RD STE 408
MIAMI BEACH FL
33140-3343
US

IV. Provider business mailing address

975 ARTHUR GODFREY RD STE 408
MIAMI FL
33140-3343
US

V. Phone/Fax

Practice location:
  • Phone: 305-672-7337
  • Fax:
Mailing address:
  • Phone: 305-385-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0056607
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME0056607
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: