Individual
LORRAINE BEATRIZ HERNANDEZ POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4675 W 18TH CT APT 405, HIALEAH, FL 33012-2842
(786) 890-9915
Mailing address
4675 W 18TH CT APT 405, HIALEAH, FL 33012-2842
(786) 890-9915
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
23-497
WI
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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