Basic Information
| Provider Information | |||||||||
| NPI: | 1134154214 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JENNIFER POLLAK MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4340 SHERIDAN ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330213567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549899998 | ||||||||
| FaxNumber: | 9544269488 | ||||||||
| Practice Location | |||||||||
| Address1: | 4340 SHERIDAN ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330213567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549899998 | ||||||||
| FaxNumber: | 9544269488 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 11/05/2013 | ||||||||
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| AuthorizedOfficialLastName: | POLLAK | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9549899998 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VF0040X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
No ID Information.