Provider Demographics
NPI:1417029109
Name:POLCZ, TIBOR EMIL (MD)
Entity Type:Individual
Prefix:
First Name:TIBOR
Middle Name:EMIL
Last Name:POLCZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9868 S STATE ROAD 7
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-4602
Mailing Address - Country:US
Mailing Address - Phone:561-736-6006
Mailing Address - Fax:561-736-5788
Practice Address - Street 1:9868 S STATE ROAD 7
Practice Address - Street 2:SUITE 320
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-4602
Practice Address - Country:US
Practice Address - Phone:561-736-6006
Practice Address - Fax:561-736-5788
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57063207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F64023Medicare UPIN