Provider Demographics
NPI:1235951757
Name:POLANCO, CHRISTINA LYNN
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNN
Last Name:POLANCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 SW 27TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-4899
Mailing Address - Country:US
Mailing Address - Phone:571-488-8242
Mailing Address - Fax:
Practice Address - Street 1:3327 SW 27TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-4899
Practice Address - Country:US
Practice Address - Phone:571-488-8242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator