MEDICARE: MR. SAMUEL GILBERT ISAACS MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW1587	FL

General Provider Information

NPI Number	:	1801923552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SAMUEL GILBERT ISAACS MSW, LCSW

Provider Business Mailing Address
First Line	:	7590 MIRABELLA DR
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-6131
Country	:	US
Telephone Number	:	561-239-9928
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 GLADES RD STE 205EAST
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33431-7386
Country	:	US
Telephone Number	:	561-338-5260
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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