Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | 06001 | FL |
NPI | 1255585923 |
---|---|
Provider Name | Dr. Danilo Polanco |
First Address | Orlando, FL 32822 |
Second Address | Orlando, FL 32822-4818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2008 |
Last Update Date | 07/11/2008 |