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General NPI Number Information
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NPI Number | 1053789982
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Entity Type | Individual
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Provider Name | ERNEST POLLEY JR.
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Gender | Male
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 1800 MERCY DR
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City | ORLANDO
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State | FL
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Zip | 32808-5646
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Country | US
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Telephone | 407-875-3700
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Fax | 407-659-0411
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Provider Business Mailing Address
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Address Line | 1800 MERCY DR
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City | ORLANDO
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State | FL
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Zip | 32808-5646
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Country | US
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Telephone | 407-875-3700
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Fax | 407-659-0411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN403501
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License Number State | FL
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