MEDICARE: MR. JOHN R POLLARD ARNP

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	363L00000X	Nurse Practitioner	1827122	FL

General Provider Information

NPI Number	:	1326030537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN R POLLARD ARNP

Provider Business Mailing Address
First Line	:	PO BOX 1312
Second Line	:
City	:	MULBERRY
State	:	FL
Zip	:	33860-1312
Country	:	US
Telephone Number	:	863-619-5201
Fax Number	:	863-646-8575

Provider Business Practice Location Address
First Line	:	1310 N CHURCH AVE
Second Line	:
City	:	MULBERRY
State	:	FL
Zip	:	33860-2047
Country	:	US
Telephone Number	:	863-619-5201
Fax Number	:	863-646-8575

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	07/08/2007

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