Aivlys Perez Polanco, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME130895 Issued in FL

Practice address

8209 State Road 54
New Port Richey, FL 34655-3016

Phone

(727) 569-1055

Fax

(727) 569-1505

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Recinto de Ciencias Medicas

  • Allergy & Immunology Physician
  • San Juan, PR
  • NPI 1184804361
  NPD (past)
• Recinto de Ciencias Medicas

  • Dermatology Physician
  • San Juan, PR
  • NPI 1295760676
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1245307453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN",
            "address_2": "SUITE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517176",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8209 STATE ROAD 54",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346553016",
            "telephone_number": "727-569-1055",
            "fax_number": "727-569-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ POLANCO",
        "first_name": "AIVLYS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "FL",
            "license": "ME130895",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME130895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pepin Academies of Pasco County Inc
• Bella Peralta, P.T.
• Sheila Percha
• Chad Perdue, CAP .0100530
• Perez Health Care Group Inc
• Larry Michael Perich, D.O.
• Maverick Michael Perich, DO
• Tanya D Perich, D.O.
• Periodontal Health Center, PL
• Sameea Perkins

• Dermatology Physician in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.