Perez Polanco, Jorge L

Perez Polanco, Jorge L is an individual health care provider with primary practice located at 119 Oakfield Dr , Brandon FL 33511-5779. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Perez Polanco, Jorge L can be contacted via phone (813) 681-0038.

Contact Information

Primary practice address
119 Oakfield Dr Brandon FL 33511-5779
Phone: (813) 681-0038
Fax: (239) 574-1451
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME94246 Florida

Profile Details

NPI number 1538158761
LBN Legal business name Perez Polanco, Jorge L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2005
Last updated Dec 16th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538158761 NPPES
Florida MEDICAID 274617400
Florida Other P00288529
Florida Other 30018
Florida Other 1865320

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