Healthcare Provider Details

I. General information

NPI: 1497734669
Provider Name (Legal Business Name): CARL CHRISTOPHER EIERLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S PINE ISLAND RD STE 300
PLANTATION FL
33324-3166
US

IV. Provider business mailing address

600 S PINE ISLAND RD STE 300
PLANTATION FL
33324-3166
US

V. Phone/Fax

Practice location:
  • Phone: 954-473-6344
  • Fax:
Mailing address:
  • Phone: 954-473-6344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME117953
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number223917
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: