Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | ME144956 | FL |
NPI | 1326493263 |
---|---|
Provider Name | Michelle Mary Issac |
First Address | Atlanta, GA 30374-3144 |
Second Address | Miami, FL 33176-2118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2016 |
Last Update Date | 07/07/2020 |