Provider Demographics
NPI:1467635482
Name:ISAAC, EMMANUEL ROSIER (DO)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:ROSIER
Last Name:ISAAC
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 E HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-3521
Mailing Address - Country:US
Mailing Address - Phone:954-400-1588
Mailing Address - Fax:888-815-1215
Practice Address - Street 1:823 E HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-3521
Practice Address - Country:US
Practice Address - Phone:954-400-1588
Practice Address - Fax:888-815-1215
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001255700Medicaid
FL001255700Medicaid