Individual
MARESSA T POLLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 HEALTH PARK BLVD, ST AUGUSTINE, FL 32086-5784
(904) 819-4363
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MA10488200
NJ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME135901
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024549900
—
FL
05
—
07914
—
LA
Enumeration date
05/23/2007
Last updated
07/12/2024
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