DR. JESSE POLANCO (NPI# 1992211767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992211767 |
| Entity Type | Individual |
| Full Name | DR. JESSE POLANCO |
| Credential | PT, DPT |
| Practice Address |
4019 Henderson Blvd Tampa FL 33629-4939 |
| Mailing Address |
100 W 169th St Apt 2 Bronx NY 10452-2808 |
| Practice Telephone | 8133950018 |
| Mailing Telephone | 9176017515 |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2019-10-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT33217 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4019 HENDERSON BLVD |
| City | TAMPA |
| State | FL |
| Zip Code | 33629-4939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275188849 | Practical Rehab LLC | Physical Therapist | 4019 Henderson Blvd, Tampa, FL 33629-4939 | 2019-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162612 | Jake Morris | Counselor | 4003 W Morrison Ave, Tampa, FL 33629 | 2018-04-25 |
| 1689192411 | Madalyn Turner | Chiropractor | 3409 W Bay To Bay Blvd Ste B, Tampa, FL 33629 | 2017-08-31 |
| 1063865673 | South Tampa Dental Studio | Dentist | 4306 West Kensington Ave., Tampa, FL 33629 | 2016-07-19 |
| 1093198160 | Mi Ae Kwon | Dentist | 3739 W. Neptune St., Tampa, FL 33629 | 2015-07-07 |
| 1013394568 | Etairos Health, Inc | In Home Supportive Care | 2301 W Palm Ave, Tampa, FL 33629 | 2015-05-05 |
| 1053702589 | Kantilal N. Bhadja, Md | Internal Medicine | 4223 W. El Prado Blvd, Tampa, FL 33629 | 2015-02-05 |
| 1801174016 | Wang & Cortes Dental | Dentist | 1008 South Clearview Avenue, Tampa, FL 33629 | 2011-07-22 |
| 1174826176 | Jada Rae Danielle Traub | Behavioral Analyst | 3271 S. Macdill Ave, Tampa, FL 33629 | 2010-12-13 |
| 1275849846 | Kara Dawson | Physical Therapy Assistant | 3614 South Dale Mabry, Tampa, FL 33629 | 2010-08-20 |
| 1225350580 | Monteleone & Kessler, P.l. | Dentist | 4014 W. Estrella St., Suite B, Tampa, FL 33629 | 2010-02-26 |
| Find all providers in zip 33629 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164044590 | Prestige Health & Performance | Physical Therapist | 20354 Chestnut Grove Dr, Tampa, FL 33647-3344 | 2020-05-07 |
| 1710519806 | Shawna Rae Sprout | Physical Therapist | 6417 E County Line Rd Ste 100, Tampa, FL 33647-1855 | 2020-02-07 |
| 1922556448 | Richard Scafidi | Physical Therapist | 1175 E Kennedy Blvd, Apt 843, Tampa, FL 33602-3545 | 2016-09-13 |
| 1477984896 | Gulfcoast Spine Institute Pa | Physical Therapist | 6101 Webb Rd., Suite 304, Tampa, FL 33615-2866 | 2013-12-11 |
| 1659622496 | Maria Ann Silverberg | Physical Therapist | 10414 Butia Pl, Tampa, FL 33618-4118 | 2012-09-19 |
| 1215064944 | Sarah E Swigart | Physical Therapist | 17200 Commerce Park Blvd, Tampa, FL 33647-2600 | 2007-02-28 |
| 1407929359 | Sherrice Broussard Rose | Physical Therapist | 2307 S Dale Mabry Hwy Ste F, Tampa, FL 33629-6322 | 2006-11-16 |
| 1164412805 | Cynthia Goode | Physical Therapist | 2106 S Lois Ave, Tampa, FL 33629-5602 | 2005-10-25 |
| 1508856261 | David Newman | Physical Therapist | 3515 E Fletcher Ave, Mdc 90, Tampa, FL 33613-4706 | 2005-10-25 |
| 1770181372 | Jordan Noga | Physical Therapist | 10272 Causeway Blvd, Tampa, FL 33619-6606 | 2020-10-15 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.