Individual
JONAS ISAAC POLOGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11375 CORTEZ BLVD, BROOKSVILLE, FL 34613-5409
(352) 596-6632
Mailing address
7700 W SUNRISE BLVD, PLANTATION, FL 33322-4113
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME141662
FL
Other
Enumeration date
04/06/2016
Last updated
07/09/2019
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