Provider Demographics
NPI:1336974435
Name:CENDAN, ISIS
Entity type:Individual
Prefix:
First Name:ISIS
Middle Name:
Last Name:CENDAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12651 S DIXIE HWY STE 320
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-5964
Mailing Address - Country:US
Mailing Address - Phone:305-300-3121
Mailing Address - Fax:
Practice Address - Street 1:12651 S DIXIE HWY STE 320
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-5964
Practice Address - Country:US
Practice Address - Phone:305-300-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035132363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health