Provider Demographics
NPI:1952390452
Name:ISA, ARNALDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNALDO
Middle Name:
Last Name:ISA
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 1:301 N MAITLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4723
Mailing Address - Country:US
Mailing Address - Phone:407-647-5996
Mailing Address - Fax:321-397-0258
Practice Address - Street 1:301 N MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4723
Practice Address - Country:US
Practice Address - Phone:407-647-5996
Practice Address - Fax:321-397-0258
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME007490914174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL254875500Medicaid
FLG66622Medicare UPIN
FL254875500Medicaid