Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME92336 | FL |
NPI | 1003865957 |
---|---|
Provider Name | Dr. Mayer Michael Eisenfeld |
First Address | St Petersburg, FL 33701-1547 |
Second Address | St Petersburg, FL 33704-4222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 06/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
273884800 | (05) | FL |
C42047 | (02) | FL |