| Mauricio Polanco, PA | |
|
13020 N Telecom Pkwy, Temple Terrace, FL 33637-0925 | |
| (813) 978-9700 | |
| (813) 558-6187 |
| Full Name | Mauricio Polanco |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 13020 N Telecom Pkwy, Temple Terrace, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790099281 | NPI | - | NPPES |
| 002622500 | Medicaid | FL | |
| Y05HF | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9104523 (Florida) | Primary |
| Entity Name | Musculoskeletal Institute Chartered |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386639920 PECOS PAC ID: 1052224102 Enrollment ID: O20031106000215 |
| Mailing Address | Practice Location Address |
|---|---|
| Mauricio Polanco, PA 13020 N Telecom Pkwy, Temple Terrace, FL 33637-0925 Ph: (813) 978-9700 | Mauricio Polanco, PA 13020 N Telecom Pkwy, Temple Terrace, FL 33637-0925 Ph: (813) 978-9700 |
Shane Michael Anderson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5901 E Fowler Ave Ste 100, Temple Terrace, FL 33617 Phone: 813-978-9700 Fax: 813-558-6185 |
Georgina R Crago, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 13020 N Telecom Pkwy, Temple Terrace, FL 33637 Phone: 813-978-9700 Fax: 813-972-5055 |
Leticia S Worsham, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 13020 N Telecom Pkwy, Temple Terrace, FL 33637 Phone: 813-978-9700 Fax: 813-972-5055 |
Nicole R Ploger, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 13020 N Telecom Pkwy, Temple Terrace, FL 33637 Phone: 813-978-9700 Fax: 813-558-6187 |
Nathan Bevan, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 13020 N Telecom Pkwy, Temple Terrace, FL 33637 Phone: 813-978-9700 Fax: 813-558-6186 |
Shannon Rose Rodriguez, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 13020 N Telecom Pkwy, Temple Terrace, FL 33637 Phone: 813-978-9700 Fax: 813-558-6185 |
Kristin D. Nelson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 11420 N 56th St, Temple Terrace, FL 33617 Phone: 813-915-5459 |