Provider Demographics
NPI:1013902436
Name:VAISMAN, ISAAC (MD)
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:VAISMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 ALTON RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2948
Mailing Address - Country:US
Mailing Address - Phone:954-547-5995
Mailing Address - Fax:
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:RADIATION BLDG
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140
Practice Address - Country:US
Practice Address - Phone:305-535-3400
Practice Address - Fax:305-535-3418
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00431722085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23531OtherBCBS PROVIDER NUMBER
FLP00128OtherFREEDOM
FL4583391OtherAETNA PROVIDER NUMBER
FLQMP000003725630OtherMOLINA MCD
FL4102221OtherGHI PROVIDER NUMBER
FL4416OtherTOTAL HLTH CH PROVIDER #
FL5735OtherNHP THRU PMG PROVIDER #
FL165336OtherWELLCARE PROVIDER #
FL215074OtherAMERIGROUP PROVIDER NUM.
FL3338532OtherCIGNA
FL165336OtherWELLCARE (MEDICARE AND MEDICAID)
FL374094300Medicaid
FLQMP000003837485OtherMOLINA MCR
FL165336OtherWELLCARE
FLNB436OtherFL HF MEDICARE
FLP0003162OtherFLORIDA HEALTHCARE PLUS
FL206646OtherAVMED PROVIDER NUMBER
FL6404OtherDIMENSION HEALTH
FL6404OtherDIMENSION PROVIDER NUMBER
FL786828OtherFIRST HEALTH PROVIDER #
FLP510124OtherOPTIMUM
FL4102221OtherGHI PROVIDER NUMBER
FL23531VMedicare PIN