Individual
DR. JESSE POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4019 HENDERSON BLVD, TAMPA, FL 33629-4939
(813) 395-0018
Mailing address
100 W 169TH ST APT 2, BRONX, NY 10452-2808
(917) 601-7515
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT33217
FL
Other
Enumeration date
12/15/2017
Last updated
10/24/2019
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