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Individual

JESSICA MARIE POLUTCHKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
10080 SW INNOVATION WAY STE 201, PORT ST LUCIE, FL 34987-2129
(772) 345-8100
Mailing address
PO BOX 748817, ATLANTA, GA 30374-8817
(813) 286-0033
(813) 282-1806

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9117407
FL
363AM0700X
Medical Physician Assistant
9117407
FL

Other

Enumeration date
06/09/2023
Last updated
12/11/2025
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