Individual
AIVLYS PEREZ POLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8209 STATE ROAD 54, NEW PORT RICHEY, FL 34655-3016
(727) 569-1055
(727) 569-1505
Mailing address
151 SOUTHHALL LN, SUITE 300, MAITLAND, FL 32751-7176
(407) 875-2080
(407) 650-3544
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME130895
FL
207ND0900X
Dermatopathology Physician
ME130895
FL
Other
Enumeration date
11/30/2006
Last updated
04/24/2017
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