Provider Demographics
NPI:1801882238
Name:SHUBICH, ISAAC N (MD)
Entity type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:N
Last Name:SHUBICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 SW 62ND AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3009
Mailing Address - Country:US
Mailing Address - Phone:305-662-8316
Mailing Address - Fax:305-663-8513
Practice Address - Street 1:3100 SW 62ND AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3009
Practice Address - Country:US
Practice Address - Phone:305-662-8316
Practice Address - Fax:305-663-8513
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0029954174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE66580Medicare UPIN
FL11407ZMedicare ID - Type Unspecified