Provider Demographics
NPI:1861445041
Name:EISMAN, DIANE BATSHAW (MD)
Entity type:Individual
Prefix:PROF
First Name:DIANE
Middle Name:BATSHAW
Last Name:EISMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:17971 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2578
Mailing Address - Country:US
Mailing Address - Phone:305-932-7814
Mailing Address - Fax:305-466-9051
Practice Address - Street 1:17971 BISCAYNE BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-2578
Practice Address - Country:US
Practice Address - Phone:305-932-7814
Practice Address - Fax:305-466-9051
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0015831207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20813OtherNEIGHBORHOOD HEALTH PARTNERSHIP
FL93004OtherBLUE CROSS BLUE SHIELD
FL080186625OtherRAILROAD MEDICARE
FL2271388OtherCIGNA
FL0004110541OtherAETNA
FL677144OtherUNITED HEALTH CARE
FL080186625OtherRAILROAD MEDICARE
FL677144OtherUNITED HEALTH CARE