Christopher Polanco

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11015732 Issued in FL

Practice address

2665 S Bayshore Dr Ste 220
Coconut Grove, FL 33133-5402

Phone

(866) 918-2114

NPI assigned

Oct 22, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Public Health Trust of Miami Dade County Florida

  • Hospitalist Physician
  • Miami, FL
  • NPI 1043395460
  Medicare reassignment NPD
• Public Health Trust of Miami Dade County Florida

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Opa-Locka, FL
  • NPI 1063417483
  Medicare reassignment NPD
• Public Health Trust of Miami Dade County Florida

  • General Practice Physician
  • Miami, FL
  • NPI 1134384423
  Medicare reassignment NPD
• Public Health Trust of Dade County Florida

  • Pediatric Cardiology Physician
  • Miami, FL
  • NPI 1952056111
  NPD
• Public Health Trust of Miami Dade County Florida

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Miami, FL
  • NPI 1366514705
  NPD
• Public Health Trust of Miami Dade County Florida

  • Urgent Care Clinic/Center
  • Miami Beach, FL
  • NPI 1578418232
  NPD
• Public Health Trust of Miami Dade County Florida

  • General Practice Physician
  • Hialeah, FL
  • NPI 1841149093
  NPD

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1306500756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 NW 199TH LN",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330152157",
            "telephone_number": "786-797-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2665 S BAYSHORE DR STE 220",
            "city": "COCONUT GROVE",
            "state": "FL",
            "postal_code": "331335402",
            "telephone_number": "866-918-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11015732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Joseph Parr, DDS
• Rafael Pena Pena, APRN
• Alberto A Penalver, MD
• Joanes Perez
• Howard Newton Pitt
• Sofia Poma, PHD
• Fernanda Ponce
• Prime Sports Physical Therapy
• Prosthodontic Dentistry of S FL
• Jessie Raya

• Psychiatric/Mental Health Nurse Practitioner in Coconut Grove, FL
• Providers in Coconut Grove, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.