Provider Demographics
NPI:1144508631
Name:FARIN, ISAAC
Entity type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:
Last Name:FARIN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ISAAC
Other - Middle Name:
Other - Last Name:FARIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:19501 W COUNTRY CLUB DR APT 1414
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2477
Mailing Address - Country:US
Mailing Address - Phone:305-205-0525
Mailing Address - Fax:
Practice Address - Street 1:20197 NE 16TH PL FL 2
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-2721
Practice Address - Country:US
Practice Address - Phone:305-332-7181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2538106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist