Provider Demographics
NPI:1033643911
Name:ISSAC, SONY M (MD)
Entity Type:Individual
Prefix:DR
First Name:SONY
Middle Name:M
Last Name:ISSAC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 016960
Mailing Address - Street 2:C-206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101
Mailing Address - Country:US
Mailing Address - Phone:305-243-6605
Mailing Address - Fax:305-243-4650
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-9420
Practice Address - Fax:305-243-4650
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME156510208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation