Individual
LUCIA A POLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4518 ROSS LANIER LN, KISSIMMEE, FL 34758-2135
(347) 399-9312
Mailing address
4518 ROSS LANIER LN, KISSIMMEE, FL 34758-2135
(347) 399-9312
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
389644031
NY
Other
Enumeration date
09/24/2009
Last updated
10/29/2009
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