Provider Demographics
NPI:1447361662
Name:SOUFFRONT, ISABEL (MD)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:SOUFFRONT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:646-778-5550
Mailing Address - Fax:
Practice Address - Street 1:848 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-4316
Practice Address - Country:US
Practice Address - Phone:954-420-7324
Practice Address - Fax:954-781-0860
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209518207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH13673Medicare UPIN