Healthcare Provider Details

I. General information

NPI: 1245275643
Provider Name (Legal Business Name): DR. JANET POLITO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BAILEY LN SUITE 105
NAPLES FL
34105-8522
US

IV. Provider business mailing address

2500 QUANTUM LAKES DR SUITE 108
BOYNTON BEACH FL
33426-8324
US

V. Phone/Fax

Practice location:
  • Phone: 239-436-3569
  • Fax:
Mailing address:
  • Phone: 561-244-3643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberOS6116
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS6116
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: