Healthcare Provider Details

I. General information

NPI: 1033526553
Provider Name (Legal Business Name): ANGELA POLCHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA PRITTS

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3438 DUCK AVE
KEY WEST FL
33040-4427
US

IV. Provider business mailing address

1107 KEY PLZ # 268
KEY WEST FL
33040-4077
US

V. Phone/Fax

Practice location:
  • Phone: 305-293-4233
  • Fax:
Mailing address:
  • Phone: 305-293-4233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11018656
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: