Provider Demographics
NPI:1265725519
Name:ISAAK, JOHN (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ISAAK
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 1:31201 US HIGHWAY 19 N STE 3
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-4422
Mailing Address - Country:US
Mailing Address - Phone:727-741-8355
Mailing Address - Fax:727-683-9575
Practice Address - Street 1:31201 US HIGHWAY 19 N
Practice Address - Street 2:ST 3
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-4422
Practice Address - Country:US
Practice Address - Phone:727-741-8355
Practice Address - Fax:339-230-0927
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119308208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01790595Medicare PIN
FLHX093ZMedicare PIN
FL012935500Medicaid
FLHX093ZMedicare PIN