| NPI | 1376689711 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2007-01-30 |
| Last Updated | 2014-03-28 |
| Authorized Official | Ananthakrishna Pillai DOCTOR Phone: 8635343737 |
| Mailing Address | 1265 E Main St Bartow, FL 33830-5006 United States Phone: (863) 534-3737 | Fax: (863) 533-6323 📍 View Map |
| Primary Practice Address | 1265 E Main St Bartow, FL 33830-5006 United States Phone: (863) 534-3737 | Fax: (863) 533-6323 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | FL | 067708600 | - |
| Other (non-Medicare) | FL | 59264 | BCBS ID # |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 208000000X – Pediatrics | FL | ME0029864 |
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About NPI 1376689711
Polk Pediatrics is an organization registered in the CMS NPPES NPI Registry with NPI number 1376689711. The primary specialty listed is Pediatrics. The organization is located in Bartow, FL. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-01-30. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1376689711?
NPI 1376689711 belongs to Polk Pediatrics, a Pediatrics in Bartow, FL. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1376689711 active?
The current status of NPI 1376689711 in the NPPES registry is Active. The record was last updated on 2014-03-28.
What specialty is NPI 1376689711?
NPI 1376689711 is classified under the taxonomy Pediatrics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1376689711?
You can verify NPI 1376689711 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1376689711?
The primary practice address on file for NPI 1376689711 is 1265 E Main St, Bartow, FL 33830-5006. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1376689711 issued?
NPI 1376689711 was first issued (enumerated) on 2007-01-30. The NPPES record was last updated on 2014-03-28.
Practice Location Map
Polk Pediatrics is located at 1265 E Main St, Bartow, FL. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Polk Pediatrics. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1376689711. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pediatrics | ME0029864 | FL |