Healthcare Provider Details

I. General information

NPI: 1750201208
Provider Name (Legal Business Name): ISABELLA RUNDELL CAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9452 SW 77TH AVE APT R3
MIAMI FL
33156-7977
US

IV. Provider business mailing address

9452 SW 77TH AVE APT R3
MIAMI FL
33156-7977
US

V. Phone/Fax

Practice location:
  • Phone: 305-563-0300
  • Fax:
Mailing address:
  • Phone: 305-563-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberAA1226
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: