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NPI Code Detail

MEDICARE: FREDERICK C POLSKY, D.O., PA

MEDICARE: FREDERICK C POLSKY, D.O., PA
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
1207R00000XInternal Medicine PhysicianOS3755FL

General Provider Information

NPI Number : 1407171648
Entity Type Code : Organization
Provider Name (Legal Business Name) : FREDERICK C POLSKY, D.O., PA
Provider Business Mailing Address
First Line : 8327 W ATLANTIC BLVD
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-7452
Country : US
Telephone Number : 954-755-2468
Fax Number : 954-755-5436
Provider Business Practice Location Address
First Line : 8327 W ATLANTIC BLVD
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33071-7452
Country : US
Telephone Number : 954-755-2468
Fax Number : 954-755-5436
Authorized Official
Title or Position : PRESIDENT
Name : DR. FREDERICK C POLSKY
Credential : D.O.
Telephone Number : 954-755-2468
Provider Enumeration Date : 03/31/2010
Last Update Date : 03/31/2010

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