Healthcare Provider Details

I. General information

NPI: 1639159833
Provider Name (Legal Business Name): SANJAI ISAAC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WOODCOCK RD STE 120
ORLANDO FL
32803-3509
US

IV. Provider business mailing address

3308 PRESTON RD 350-287
PLANO TX
75093-7453
US

V. Phone/Fax

Practice location:
  • Phone: 407-792-1968
  • Fax: 407-641-5179
Mailing address:
  • Phone: 214-471-5975
  • Fax: 866-476-1204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberJ6498
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberJ6498
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME158582
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: