Donna Polelle, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA10941 Issued in FL

Practice address

4202 E Fowler Ave
Pcd1017
Tampa, FL 33620-6750

Phone

(813) 974-9844

Fax

(813) 974-0822

NPI assigned

Aug 24, 2009

Last updated

Jul 19, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1881827988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917770",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328910001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 E FOWLER AVE",
            "address_2": "PCD1017",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336206750",
            "telephone_number": "813-974-9844",
            "fax_number": "813-974-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLELLE",
        "first_name": "DONNA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA10941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004428700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "S00QC",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Polaris Pharmacy Services of Tampa, LLC (Prime Pharmacy East)
• Joseph Polcaro, D.O.
• Simran Polce, MD
• Monica Evelyn Polcz, MD
• Joshua Robert Polege, A.A.
• Allison Ilene Polender, M.D.
• Kaila Poleon
• Keisha Marie Poleon, PA-C
• Megan Lanay Polin, BS
• Katrina Polite

• Speech-Language Pathologist in Tampa, FL
• Providers in Tampa, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.