Provider Demographics
NPI:1386618577
Name:POLSKY, FREDERICK C (DO)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:C
Last Name:POLSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8327 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7452
Mailing Address - Country:US
Mailing Address - Phone:954-755-2468
Mailing Address - Fax:954-755-5436
Practice Address - Street 1:8327 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7452
Practice Address - Country:US
Practice Address - Phone:954-755-2468
Practice Address - Fax:954-755-5436
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL050003755207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL84241VMedicare PIN
FLE32160Medicare UPIN