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General NPI Number Information
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NPI Number | 1154563245
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Entity Type | Individual
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Provider Name | WISNER JOSEPH PHILEMY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2009
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Last Update Date | 09/13/2025
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Provider Practice Location Address
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Address Line | 315-321 CII 25 NE
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City | SAN JUAN
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State | PUERTO RICO
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Zip | 00920
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Country | UM
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Telephone |
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Fax |
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Provider Business Mailing Address
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Address Line | 32 CALLE ORION
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City | CAROLINA
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State | PR
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Zip | 00979-1627
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Country | US
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Telephone | 954-990-9495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 24194
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | 24194
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License Number State | PR
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Taxonomy #4
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 24194
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License Number State | PR
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