Provider Demographics
NPI:1679202618
Name:DOCTORS ISAAC & ISAAC PSYCHIATRIC PA
Entity Type:Organization
Organization Name:DOCTORS ISAAC & ISAAC PSYCHIATRIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSAC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-614-5600
Mailing Address - Street 1:3310 CLEVELAND HEIGHTS BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4717
Mailing Address - Country:US
Mailing Address - Phone:718-614-5600
Mailing Address - Fax:718-460-0802
Practice Address - Street 1:3310 CLEVELAND HEIGHTS BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4717
Practice Address - Country:US
Practice Address - Phone:718-614-5600
Practice Address - Fax:718-460-0802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health