Individual
ALTA B ISAAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2615 FAIRWAYS DR, HOMESTEAD, FL 33035-1173
(786) 972-4700
Mailing address
2615 FAIRWAYS DR, HOMESTEAD, FL 33035-1173
(786) 972-4700
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
476867
FL
Other
Enumeration date
06/14/2019
Last updated
05/26/2020
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