Polanco, Mauricio

Polanco, Mauricio is an individual health care provider with primary practice located at 13020 N Telecom Pkwy , Temple Terrace FL 33637-0925. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Polanco, Mauricio can be contacted via phone (813) 978-9700.

Contact Information

Primary practice address
13020 N Telecom Pkwy Temple Terrace FL 33637-0925
Fax: (813) 558-6187
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9104523 Florida

Profile Details

NPI number 1790099281
LBN Legal business name Polanco, Mauricio
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2010
Last updated Oct 13th, 2017 - about 9 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 1790099281 NPPES
Florida MEDICAID 002622500
Florida Other Y05HF

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