| Jose F Polanco Md Pa | |
|
311 3rd Ave E Bradenton FL 34208-1014 | |
| (941) 708-3358 | |
| Not Available |
| Full Name | Jose F Polanco Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 311 3rd Ave E, Bradenton, Florida |
| Authorized Official Name and Position | Jose F Polanco (OWNER) |
| Authorized Official Contact | 9417083358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jose F Polanco Md Pa 311 3rd Ave E Bradenton FL 34208-1014 Ph: (941) 708-3358 | Jose F Polanco Md Pa 311 3rd Ave E Bradenton FL 34208-1014 Ph: (941) 708-3358 |
| NPI Number | 1114177938 |
|---|---|
| Provider Enumeration Date | 09/29/2008 |
| Last Update Date | 08/30/2012 |
| Medicare PECOS PAC ID | 6406916501 |
|---|---|
| Medicare Enrollment ID | O20081119000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114177938 | NPI | - | NPPES |
| 003131900 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME73836 (Florida) | Primary |
| Provider Name | Jose F Polanco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750346086 PECOS PAC ID: 8820158991 Enrollment ID: I20081119000541 |
| Provider Name | Liliana Maria Mejia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992215230 PECOS PAC ID: 5890035828 Enrollment ID: I20190328002456 |
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