Individual
ISSAC NAGIB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.P.T.
Contact information
Practice address
1342 STATE ROAD 60 E, LAKE WALES, FL 33853-4322
(863) 676-8300
(863) 676-1300
Mailing address
1342 STATE ROAD 60 E, LAKE WALES, FL 33853-4322
(863) 676-8300
(863) 676-1300
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT3913
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
888102200
—
FL
Enumeration date
05/11/2006
Last updated
04/10/2017
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