Jesse Polanco, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT33217 Issued in FL

Practice address

4019 Henderson Blvd
Tampa, FL 33629-4939

Phone

(813) 395-0018

NPI assigned

Dec 15, 2017

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Practical Rehab LLC

  • Physical Therapist
  • Tampa, FL
  • NPI 1275188849
  NPD Authorized official
• Rehabclinics SPT Inc

  • Physical Therapist
  • Eldersburg, MD
  • NPI 1164427092
  NPD (past)

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

{
    "created_epoch": "1513296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1992211767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W 169TH ST APT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104522808",
            "telephone_number": "917-601-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4019 HENDERSON BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336294939",
            "telephone_number": "813-395-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "JESSE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-15",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT33217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Poklepovic, MD
• Christopher Daniel Pokornicki, CTRS
• Daniel Pol, LMHC
• Eva Liuva Polanco Perez
• Claribel Ruiz Polanco, B.A.
• Maria Florencia Polanco
• Mario Eduardo Polanco, D.D.S.
• Polaris Pharmacy Services of Tampa, LLC
• Joseph Polcaro, D.O.
• Simran Polce, MD

• Orthopedic Physical Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Orthopedic Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.