MEDICARE: VINCENT POLITE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1386024206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT POLITE

Provider Business Mailing Address
First Line	:	5931 BEECHMONT BLV
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5931 BEECHMONT BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32808-2314
Country	:	US
Telephone Number	:	407-592-0481
Fax Number	:

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

Provider Enumeration Date	:	06/05/2015
Last Update Date	:	06/05/2015

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Directions to “ VINCENT POLITE ” Practice Location

Language	Start Address	Practice Location

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