Provider Demographics
NPI:1063658995
Name:ISENALUMHE, ANTHONY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:ISENALUMHE
Suffix:JR
Gender:M
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:PO BOX 20494
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-0494
Mailing Address - Country:US
Mailing Address - Phone:352-515-0025
Mailing Address - Fax:352-515-0174
Practice Address - Street 1:13141 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5016
Practice Address - Country:US
Practice Address - Phone:352-515-0025
Practice Address - Fax:352-515-0174
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123669207LP2900X, 207LP2900X
CAA121470207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLLYNG3OtherBLUE CROSS BLUE SHIELD
FLIH692XMedicare PIN
FLIH692YMedicare PIN