Individual
MR. BENJAMIN MICHAEL ENSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5821 S WILLIAMSON BLVD STE 202, PORT ORANGE, FL 32128-6102
(386) 231-6325
Mailing address
5821 S WILLIAMSON BLVD STE 202, PORT ORANGE, FL 32128-6102
(386) 231-6325
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107261
FL
363AM0700X
Medical Physician Assistant
PA9107261
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015492900
—
FL
01
—
PA9107261
PHYSICIAN ASSISTANT LICENSE
FL
01
—
W6014
HFMG
FL
Enumeration date
07/08/2013
Last updated
03/16/2026
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