Stephanie Polania, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

PA9113707 Issued in FL

Practice address

4269 N. Pine Island Rd.
Sunrise, FL 33351-6044

Phone

(954) 578-0200

Fax

(954) 578-0050

NPI assigned

Nov 11, 2020

Last updated

Oct 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Archbold Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MD Healthcare Network LLC

  • Family Medicine Physician
  • Weston, FL
  • NPI 1962892141
  NPD (past)
• Sunset Strip Medical Center, Inc

  • Internal Medicine Physician
  • Sunrise, FL
  • NPI 1881607562
  NPD (past)

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1619579075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4269 N. PINE ISLAND RD.",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516044",
            "telephone_number": "954-578-0200",
            "fax_number": "954-578-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4269 N. PINE ISLAND RD.",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516044",
            "telephone_number": "954-578-0200",
            "fax_number": "954-578-0050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Congress Park Dr Ste 245",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334454605",
            "country_code": "US",
            "telephone_number": "954-464-1488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLANIA",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2023-10-12",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9113707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "http://psychiatrywellnesscenter.org/contact/",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "Psychiatry Wellness Center PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "contact",
            "address_1": "6801 Lake Worth Rd Ste 213-214",
            "city": "Greenacres",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334672955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "ARCHBOLD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Medicine Physician in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.