Harry W Eichenbaum MD PA

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

MES 100677 Issued in FL

Legal business name

HARRY W EICHENBAUM MD PA

Practice address

4320 Central Ave
St Petersburg, FL 33711-1141

Phone

(727) 345-3621

Fax

(727) 381-4934

NPI assigned

Feb 11, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark S Eichenbaum, MDNPI 1871764977

Title

President

Phone

(727) 345-3621

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Samuel Eichenbaum, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • St Petersburg, FL
  • NPI 1871764977
  Medicare reassignment NPD Authorized official
• Stephanie Franzen Carmack, ARNP

  • Nurse Practitioner
  • St Petersburg, FL
  • NPI 1497028484
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1265671549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337111141",
            "telephone_number": "727-345-3621",
            "fax_number": "727-381-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111141",
            "telephone_number": "727-345-3621",
            "fax_number": "727-381-4934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRY W EICHENBAUM MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-11",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "EICHENBAUM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-345-3621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "MES 100677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John B Harrison, DDS,MSC
• Lindsay Harrison, M.A., LMHC
• Phillind Kayon Harrison Sr.
• Harrisrogers Home Health Organization
• Kaela Janelle Harron, DO
• Brendon Hart, D.O
• Molly Marie Hart, PT, DPT
• Morgan Hart, PA-C
• Bryan James Harter, D.P.T.
• Marigene G Hartker, MD

• Geriatric Medicine (Internal Medicine) Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.