MEDICARE: EMILY EISELE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor		FL

General Provider Information

NPI Number	:	1518834845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY EISELE

Provider Business Mailing Address
First Line	:	883 SPRING PALMS LOOP
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-5339
Country	:	US
Telephone Number	:	321-313-9790
Fax Number	:

Provider Business Practice Location Address
First Line	:	11537 LAKE UNDERHILL RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32825-5001
Country	:	US
Telephone Number	:	407-821-3098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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Directions to “ EMILY EISELE ” Practice Location

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