Organization
WAYNE ISAACSON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE ISAACSON (MD)
(239) 939-7375
Entity
Organization
Contact information
Practice address
4035 EVANS AVE, STE 1, FORT MYERS, FL 33901-9308
(239) 939-7375
(239) 939-5105
Mailing address
4035 EVANS AVE, STE 1, FORT MYERS, FL 33901-9308
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME0071098
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1020685
OTHER ID NUMBER
—
Enumeration date
08/20/2006
Last updated
07/31/2007
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