MEDICARE: JENNIFER POLANCO

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	111N00000X	Chiropractor	CH15602	FL
2	225700000X	Massage Therapist	MA63328	FL

General Provider Information

NPI Number	:	1457955882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER POLANCO

Provider Business Mailing Address
First Line	:	2607 HERWALD ST
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-5113
Country	:	US
Telephone Number	:	941-323-9227
Fax Number	:

Provider Business Practice Location Address
First Line	:	2607 HERWALD ST
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-5113
Country	:	US
Telephone Number	:	941-323-9227
Fax Number	:

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

Provider Enumeration Date	:	11/25/2020
Last Update Date	:	09/11/2025

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Directions to “ JENNIFER POLANCO ” Practice Location

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