Individual
MRS. JESSICA POLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 PABLO ST, LAKELAND, FL 33803-3818
(863) 284-5020
(863) 284-5912
Mailing address
1324 LAKELAND HILLS BLVD, ATTN: MANAGED CARE DEPT., LAKELAND, FL 33805-4543
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
9293649
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9293649
FL
Other
Enumeration date
09/16/2017
Last updated
07/20/2022
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