MEDICARE: DR. ESHBAN EMMANUEL 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
1	207Q00000X	Family Medicine Physician	25MA12536800	NJ
2	207Q00000X	Family Medicine Physician	ME155763	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356801518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ESHBAN EMMANUEL MD

Provider Business Mailing Address
First Line	:	3801 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-4801
Country	:	US
Telephone Number	:	772-223-4999
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-4801
Country	:	US
Telephone Number	:	772-223-4999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2019
Last Update Date	:	01/19/2026

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