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ETHAN G POLSKY M.D. NPI 1871559740


NPI Information

NPI: 1871559740
Provider Name: ETHAN G POLSKY, M.D.
Classification: Urology - 2088P0231X
Entity Type: Individual

Specialization: Pediatric Urology

Organization: CHILDRENS UROLOGY GROUP PL

PECOS Registration: Yes

Address:
4712 N ARMENIA AVE
SUITE 200
TAMPA, FL
ZIP 33603
Phone: (813) 874-7500
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Ethan G Polsky, M.D. is a pediatric urology urology in Tampa, FL with 24 years of experience. The provider is surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). Ethan G Polsky, M.D. NPI is 1871559740. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF KENTUCKY COLLEGE OF MEDICINE
Graduation Year:2000

The provider's business location address is:

4712 N ARMENIA AVE
SUITE 200
TAMPA, FL
ZIP 33603-611
Phone: (813) 874-7500
Fax: (813) 877-1397

The NPI 1871559740 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/21/2006 and was last updated on 7/9/2015.


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
12088P0231XUrologyPediatric UrologyME95516FLORIDAYes

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
1275204200MEDICAIDFLORIDA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.