Provider Demographics
NPI:1326497918
Name:HILARIO A. ISABA MD PA
Entity Type:Organization
Organization Name:HILARIO A. ISABA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:HILARIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISABA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-271-6032
Mailing Address - Street 1:4910 E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1410
Mailing Address - Country:US
Mailing Address - Phone:786-271-6032
Mailing Address - Fax:305-646-1039
Practice Address - Street 1:7234 BEDLINGTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-8000
Practice Address - Country:US
Practice Address - Phone:786-271-6032
Practice Address - Fax:305-646-1039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME049241208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID