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General NPI Number Information
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NPI Number | 1710277413
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Entity Type | Individual
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Provider Name | RUBEN PEREZ POLO ARNP
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Gender | Male
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Dates
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Enumeration Date | 04/14/2011
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 18590 NW 67TH AVE STE 101
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City | HIALEAH
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State | FL
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Zip | 33015-3540
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Country | US
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Telephone | 786-454-9850
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 BLUE LAGOON DR STE 400
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City | MIAMI
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State | FL
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Zip | 33126-2051
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Country | US
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Telephone | 305-823-3312
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Fax | 305-884-3989
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 9383647
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License Number State | FL
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