Healthcare Provider Details

I. General information

NPI: 1619831641
Provider Name (Legal Business Name): DAVID DOMINIC ISNARDI II PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2025
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W WISCONSIN AVE STE 210
MILWAUKEE WI
53203-3301
US

IV. Provider business mailing address

3643 BLUEFIELD AVE
MELBOURNE FL
32934-8386
US

V. Phone/Fax

Practice location:
  • Phone: 800-535-0250
  • Fax:
Mailing address:
  • Phone: 321-446-0713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberAPRN11044143
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: