MEDICARE: DR. MITCHELL POLLAK M.D.

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	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	ME0050840	FL

General Provider Information

NPI Number	:	1770546913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL POLLAK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 9007
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33075-9007
Country	:	US
Telephone Number	:	954-803-6520
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 ROYAL PALM BLVD
Second Line	:	105
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-5733
Country	:	US
Telephone Number	:	954-345-6789
Fax Number	:	954-345-7998

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	12/07/2016

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