Provider Demographics
NPI:1407528938
Name:SARTAIN, ISABELLA CONSTANTINA
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:CONSTANTINA
Last Name:SARTAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7591 168TH CT N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33418
Mailing Address - Country:US
Mailing Address - Phone:316-559-5092
Mailing Address - Fax:
Practice Address - Street 1:10 GIRALDA AVE STE 100
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5303
Practice Address - Country:US
Practice Address - Phone:316-559-5092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-03
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILR2F826450962OtherBLUE CROSS BLUE SHIELD