Provider Demographics
NPI:1578703443
Name:VERTUS, ISIS A
Entity Type:Individual
Prefix:
First Name:ISIS
Middle Name:A
Last Name:VERTUS
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 1:1233 NELSON PARK CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-5973
Mailing Address - Country:US
Mailing Address - Phone:813-447-6048
Mailing Address - Fax:863-496-1518
Practice Address - Street 1:7448 LAUREL HILL OAKS CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-5273
Practice Address - Country:US
Practice Address - Phone:813-447-6048
Practice Address - Fax:863-496-1518
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker