MEDICARE: DR. VICTOR ANTHONY POLITANO JR. D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS0005193	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	82904	OTHER	FL	BCBS PROVIDER NUMBER
3	401926	OTHER	FL	CIGNA PROVIDER NUMBER
4	4307838	OTHER	FL	AETNA PROVIDER NUMBER

General Provider Information

NPI Number	:	1063497857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR ANTHONY POLITANO JR. D.O.

Provider Business Mailing Address
First Line	:	2155 NOLTE RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-8762
Country	:	US
Telephone Number	:	407-846-9247
Fax Number	:	407-846-4430

Provider Business Practice Location Address
First Line	:	2155 NOLTE RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-8762
Country	:	US
Telephone Number	:	407-846-9247
Fax Number	:	407-846-4430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	09/08/2024

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