Provider Demographics
NPI:1588870687
Name:POLYNICE, WILCHEL (RRT)
Entity type:Individual
Prefix:
First Name:WILCHEL
Middle Name:
Last Name:POLYNICE
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15913 SW 63RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-5562
Mailing Address - Country:US
Mailing Address - Phone:786-499-8645
Mailing Address - Fax:305-752-3260
Practice Address - Street 1:15913 SW 63RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-5562
Practice Address - Country:US
Practice Address - Phone:786-499-8645
Practice Address - Fax:305-752-3260
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT 8744227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered