Active NPI
Michael Alan Isicoff, MD
- Legal Medicine
- Palm Coast, FL
National Provider Identifier
1205966926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- MEOO83733
- Practice address
- 6 Office Park Dr
Palm Coast, FL 32137-3808 - Phone
- (386) 447-6615
- Fax
- (386) 447-1266
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | MEOO83733 | FL | Primary |
Addresses
Primary practice location
6 Office Park Dr
Palm Coast, FL 32137-3808
Mailing address
416 Ocean Grove Cir
St Augustine, FL 32080-8721
Phone (904) 461-1723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MEOO83733 | FL | MD | Legal Medicine |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221523200000",
"number": "1205966926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 OCEAN GROVE CIR",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320808721",
"telephone_number": "904-461-1723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 OFFICE PARK DR",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321373808",
"telephone_number": "386-447-6615",
"fax_number": "386-447-1266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISICOFF",
"first_name": "MICHAEL",
"middle_name": "ALAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2008-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "FL",
"license": "MEOO83733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.