Provider Demographics
NPI:1396379848
Name:POLAKOWSKI, JAKUB PIOTR (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAKUB
Middle Name:PIOTR
Last Name:POLAKOWSKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1044
Mailing Address - Country:US
Mailing Address - Phone:941-921-4681
Mailing Address - Fax:941-925-8576
Practice Address - Street 1:3601 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1044
Practice Address - Country:US
Practice Address - Phone:941-921-4681
Practice Address - Fax:941-925-8576
Is Sole Proprietor?:No
Enumeration Date:2020-02-24
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19228-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist