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POLK PEDIATRICS NPI 1376689711


NPI Information

NPI: 1376689711
Provider Name: POLK PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 10D0965336

Address:
1265 E MAIN ST
BARTOW, FL
ZIP 33830
Phone: (863) 534-3737
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POLK PEDIATRICS is a pediatrics in Bartow, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. POLK PEDIATRICS NPI is 1376689711. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1265 E MAIN ST
BARTOW, FL
ZIP 33830-006
Phone: (863) 534-3737
Fax: (863) 533-6323

The provider's authorized official is Ananthakrishna Pillai .
The authorized official title is Doctor and has the following contact phone number (863) 534-3737.

The CLIA number assigned to this NPI record is 10D0965336 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 3/28/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsME0029864FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1067708600MEDICAIDFLORIDA
259264OTHERFLORIDABCBS ID #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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