Individual provider Active NPI

Ana Maria Polanco, NP-C

  • Gerontology Nurse Practitioner
  • Seminole, FL
National Provider Identifier
1861090854
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11009778 Issued in FL
Practice address
10575 68TH Ave Ste A2
Seminole, FL 33772-6023
Phone
(813) 389-9516
NPI assigned
Oct 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9348748 FL
Gerontology Nurse Practitioner 363LG0600X APRN11009778 FL Primary

Addresses

Primary practice location

10575 68TH Ave Ste A2
Seminole, FL 33772-6023

Mailing address

7937 Hampton Lake Dr
Tampa, FL 33647-3662
Phone (813) 389-9516

Other practice location 1

7937 Hampton Lake Dr
Tampa, FL 33647-3662
Phone (813) 389-9516

Other names 1

  • Ana Maria Polanco Gonzalez Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9348748FLMDRegistered Nurse
APRN11009778FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca D. Martin, Arnp, P.a. CurrentSince Mar 7, 2021 Accepting new patients

Locations

10575 68th Ave
Ste A2
Seminole, FL 33772
Phone (727) 272-1844

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1861090854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7937 HAMPTON LAKE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473662",
            "telephone_number": "813-389-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10575 68TH AVE STE A2",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337726023",
            "telephone_number": "813-389-9516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7937 Hampton Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336473662",
            "country_code": "US",
            "telephone_number": "813-389-9516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "ANA",
        "middle_name": "MARIA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9348748",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11009778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANA",
            "last_name": "POLANCO GONZALEZ",
            "middle_name": "MARIA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seminole, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.