Provider Demographics
NPI:1386741585
Name:POLIN, RUTLEDGE, & FISCHER, M.D., PA
Entity type:Organization
Organization Name:POLIN, RUTLEDGE, & FISCHER, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:POLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-786-1673
Mailing Address - Street 1:34637 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2152
Mailing Address - Country:US
Mailing Address - Phone:727-786-1673
Mailing Address - Fax:717-785-0284
Practice Address - Street 1:34637 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2152
Practice Address - Country:US
Practice Address - Phone:727-786-1673
Practice Address - Fax:717-785-0284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME032947207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCF6492OtherRR MEDICARE GROUP #
FL269367400Medicaid
FL34455OtherBC/BS FL GROUP#
FL269367400Medicaid