MEDICARE: ANASTASIOS C. POLIMENAKOS MD

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	208600000X	Surgery Physician	D0101444	MD
2	2080P0202X	Pediatric Cardiology Physician	071271	GA
3	208600000X	Surgery Physician	036.120154	IL
4	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	071271	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	071271	OTHER	GA	GA LICENSES

General Provider Information

NPI Number	:	1649283516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIOS C. POLIMENAKOS MD

Provider Business Mailing Address
First Line	:	3820 NORTHDALE BLVD STE 201
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1893
Country	:	US
Telephone Number	:	813-961-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 N ARLINGTON HEIGHTS RD STE 201
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3985
Country	:	US
Telephone Number	:	800-991-6117
Fax Number	:

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	03/26/2026

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Directions to “ ANASTASIOS C. POLIMENAKOS MD” Practice Location

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