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Organization

CHARLES T POLIS JR MD PA

Active
Other names
Urology Associates
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES T POLIS JR. MD (PRESIDENT)
(941) 792-1477
Entity
Organization

Contact information

Practice address
1410 59TH STREET W, BRADENTON, FL 34209
(941) 792-1477
(941) 794-8017
Mailing address
1410 59TH STREET W, BRADENTON, FL 34209
(941) 792-1477
(941) 794-8017

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
340003525
RAILROAD MEDICARE
FL
Enumeration date
02/23/2006
Last updated
02/25/2008
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