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Individual

DR. JOSE GREGORIO POLO-CUETO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D ACN

Contact information

Practice address
4382 L B MCLEOD RD, ORLANDO, FL 32811-5619
(407) 648-0076
(407) 648-3666
Mailing address
4382 L B MCLEOD RD, ORLANDO, FL 32811-5619
(407) 648-0076
(407) 648-3666

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
20004
PR
208D00000X
General Practice Physician
Primary
ACN 946
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P423-427-73-11-0
DRIVER LICENSE
FL
Enumeration date
09/21/2012
Last updated
03/21/2016
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