MEDICARE: GRETCHEN JOY POHASKI PA C

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	363A00000X	Physician Assistant	PA820	NV
2	363A00000X	Physician Assistant	PA9106519	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306817598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRETCHEN JOY POHASKI PA C

Provider Business Mailing Address
First Line	:	1720 S ORANGE AVE
Second Line	:	SUITE 500
City	:	ORLANDO
State	:	FL
Zip	:	32806-2945
Country	:	US
Telephone Number	:	407-426-9693
Fax Number	:	407-426-9694

Provider Business Practice Location Address
First Line	:	1655 E CACTUS AVE STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7723
Country	:	US
Telephone Number	:	702-561-8600
Fax Number	:

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	11/19/2025

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