Provider Demographics
NPI:1063143600
Name:ISAACS-BENJAMIN, JUNEANN
Entity type:Individual
Prefix:
First Name:JUNEANN
Middle Name:
Last Name:ISAACS-BENJAMIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 SW 168TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-4128
Mailing Address - Country:US
Mailing Address - Phone:352-653-9488
Mailing Address - Fax:352-307-2841
Practice Address - Street 1:3003 SW 168TH LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-4128
Practice Address - Country:US
Practice Address - Phone:352-653-9488
Practice Address - Fax:352-307-2841
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management