Provider Demographics
NPI:1205158169
Name:EISENFELD, MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:EISENFELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 S.W. 87TH AVENUE
Mailing Address - Street 2:SUITE C-340
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3570
Mailing Address - Country:US
Mailing Address - Phone:305-595-0109
Mailing Address - Fax:305-595-7092
Practice Address - Street 1:2925 AVENTURA BOULEVARD
Practice Address - Street 2:SUITE 308
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-0000
Practice Address - Country:US
Practice Address - Phone:305-932-5662
Practice Address - Fax:305-932-1011
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253913207K00000X, 208000000X
FLME109241207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics