Basic Information
| Provider Information | |||||||||
| NPI: | 1144204710 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POLANCO | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | J12 CALLE 8 | ||||||||
| Address2: | URBANIZACION LA MONSERRATE | ||||||||
| City: | HORMIGUEROS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006601627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878493472 | ||||||||
| FaxNumber: | 7878493472 | ||||||||
| Practice Location | |||||||||
| Address1: | CALLE POST 18 NORTE | ||||||||
| Address2: | |||||||||
| City: | MAYAGUEZ | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878340050 | ||||||||
| FaxNumber: | 7878342104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 12471 | PR | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.