Provider Demographics
NPI:1003814187
Name:POLO MEDICAL CENTER INC
Entity Type:Organization
Organization Name:POLO MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TURKELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-998-0510
Mailing Address - Street 1:5030 CHAMPION BLVD
Mailing Address - Street 2:SUITE G-9
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2473
Mailing Address - Country:US
Mailing Address - Phone:561-998-0510
Mailing Address - Fax:561-998-0163
Practice Address - Street 1:5030 CHAMPION BLVD
Practice Address - Street 2:SUITE G-9
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2473
Practice Address - Country:US
Practice Address - Phone:561-998-0510
Practice Address - Fax:561-998-0163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005420111N00000X
FLME55498207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70891OtherBC/BS PROVIDER #
FLE72162Medicare UPIN
FLE2605ZMedicare ID - Type Unspecified
FLU27035Medicare UPIN