Provider Demographics
NPI:1134328495
Name:POLLAK, JENNIFER (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:POLLAK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4340 SHERIDAN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3567
Mailing Address - Country:US
Mailing Address - Phone:954-989-9998
Mailing Address - Fax:954-989-9979
Practice Address - Street 1:4340 SHERIDAN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3567
Practice Address - Country:US
Practice Address - Phone:954-989-9998
Practice Address - Fax:954-989-9979
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77220207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6396AMedicare PIN