Provider Demographics
NPI:1215113253
Name:EISENBERG, GAIL C (MD)
Entity type:Individual
Prefix:DR
First Name:GAIL
Middle Name:C
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3990 SHERIDAN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3661
Mailing Address - Country:US
Mailing Address - Phone:954-964-9242
Mailing Address - Fax:954-964-9279
Practice Address - Street 1:3990 SHERIDAN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3661
Practice Address - Country:US
Practice Address - Phone:954-964-9242
Practice Address - Fax:954-964-9279
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-20
Last Update Date:2008-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL408722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry