Healthcare Provider Details

I. General information

NPI: 1134154214
Provider Name (Legal Business Name): JENNIFER POLLAK MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 SHERIDAN ST SUITE 201
HOLLYWOOD FL
33021-3567
US

IV. Provider business mailing address

4340 SHERIDAN ST SUITE 201
HOLLYWOOD FL
33021-3567
US

V. Phone/Fax

Practice location:
  • Phone: 954-989-9998
  • Fax: 954-426-9488
Mailing address:
  • Phone: 954-989-9998
  • Fax: 954-426-9488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER POLLAK
Title or Position: OWNER
Credential: MD
Phone: 954-989-9998