Provider Demographics
NPI:1164240644
Name:ISAACS, KEVIN WASHINGTON SR
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:WASHINGTON
Last Name:ISAACS
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 CONROY WINDERMERE RD UNIT 1165
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5047
Mailing Address - Country:US
Mailing Address - Phone:954-812-5867
Mailing Address - Fax:
Practice Address - Street 1:601 POYDRAS ST STE 102
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-6015
Practice Address - Country:US
Practice Address - Phone:954-812-5867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor