Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | ME57063 | FL |
NPI | 1417029109 |
---|---|
Provider Name | Tibor Emil Polcz |
First Address | Boynton Beach, FL 33472-4602 |
Second Address | Boynton Beach, FL 33472-4602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 10/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F64023 | (02) |