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General NPI Number Information
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NPI Number | 1134172364
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Entity Type | Individual
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Provider Name | EUGENE HERBERT EISMAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 17971 BISCAYNE BLVD SUITE 208
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City | AVENTURA
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State | FL
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Zip | 33160-2578
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Country | US
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Telephone | 305-932-7814
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Fax | 305-466-9051
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Provider Business Mailing Address
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Address Line | 17971 BISCAYNE BLVD SUITE 208
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City | AVENTURA
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State | FL
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Zip | 33160-2578
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Country | US
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Telephone | 305-932-7814
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Fax | 305-466-9051
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME0015832
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License Number State | FL
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