Provider Demographics
NPI:1730201674
Name:ISAKSON, LOREN E (MD)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:E
Last Name:ISAKSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2655 ULMERTON RD # 225
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-3337
Mailing Address - Country:US
Mailing Address - Phone:727-222-1879
Mailing Address - Fax:855-853-7314
Practice Address - Street 1:900 CARILLON PKWY STE 301
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1115
Practice Address - Country:US
Practice Address - Phone:727-222-1879
Practice Address - Fax:855-853-7314
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY243002208000000X
GA066845207K00000X
FLME110222207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics