Individual
ETHAN G POLSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4712 N ARMENIA AVE, SUITE 200, TAMPA, FL 33603-2611
(813) 874-7500
(813) 877-1397
Mailing address
4712 N ARMENIA AVE, SUITE 200, TAMPA, FL 33603-2611
(813) 874-7500
(813) 877-1397
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
ME95516
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275204200
—
FL
Enumeration date
04/21/2006
Last updated
07/09/2015
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