Individual
ALEXEI POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5616 W NORVELL BRYANT HWY, CRYSTAL RIVER, FL 34429-7572
(352) 795-1999
Mailing address
7610 STIRLING RD APT E103, HOLLYWOOD, FL 33024-8418
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9111015
FL
Other
Enumeration date
03/22/2018
Last updated
04/05/2018
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