Individual
ERNESTO MARTELL POLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
16966 CAGAN RIDGE BLVD STE 220, CLERMONT, FL 34714-9656
(321) 843-5851
(321) 843-1673
Mailing address
16966 CAGAN RIDGE BLVD STE 220, CLERMONT, FL 34714-9656
(321) 843-5851
(321) 843-1673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9114867
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9114867
FL
Other
Enumeration date
07/26/2019
Last updated
09/19/2024
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