Provider Demographics
NPI:1265227540
Name:ISENMAN WELLNESS CARE LLC
Entity type:Organization
Organization Name:ISENMAN WELLNESS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ISENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-220-0049
Mailing Address - Street 1:1694 W HIBISCUS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-2636
Mailing Address - Country:US
Mailing Address - Phone:321-220-0049
Mailing Address - Fax:321-821-0201
Practice Address - Street 1:1694 W HIBISCUS BLVD STE A
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-2636
Practice Address - Country:US
Practice Address - Phone:321-220-0049
Practice Address - Fax:321-821-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty