Active NPI
Issac Nagib, R.P.T.
- Specialist
- Lake Wales, FL
National Provider Identifier
1861442857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PT3913
- Practice address
- 1342 State Road 60 E
Lake Wales, FL 33853-4322 - Phone
- (863) 676-8300
- Fax
- (863) 676-1300
- NPI assigned
- May 11, 2006
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | PT3913 | FL | Primary |
Addresses
Primary practice location
1342 State Road 60 E
Lake Wales, FL 33853-4322
Mailing address
1342 State Road 60 E
Lake Wales, FL 33853-4322
Phone (863) 676-8300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 888102200 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3913 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1861442857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1342 STATE ROAD 60 E",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338534322",
"telephone_number": "863-676-8300",
"fax_number": "863-676-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1342 STATE ROAD 60 E",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338534322",
"telephone_number": "863-676-8300",
"fax_number": "863-676-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGIB",
"first_name": "ISSAC",
"credential": "R.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "PT3913",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "888102200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Wales, FL
- Morning Star Health Solutions, Inc.
- Hasan M. Mousli, MD
- Multi-Specialty & Primary Care Practice Group of Lake Wales LLC
- Devin M Murphy, PTA
- Myeyedr. Optometry of Florida, LLC (MyEyeDr.)
- Ricardo James Navarro, D.O.
- Never Left Alone Concierge Services, Inc.
- New Horizons Respite Care Agency LLC
- Mara Newton
- Thuy Thi Nguyen
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.