Provider Demographics
NPI:1710627708
Name:POLANCO-HIRALDO, DANIA JOSEFINA (RRT)
Entity Type:Individual
Prefix:MRS
First Name:DANIA
Middle Name:JOSEFINA
Last Name:POLANCO-HIRALDO
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:MRS
Other - First Name:DANIA
Other - Middle Name:JOSEFINA
Other - Last Name:POLANCO-RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RRT
Mailing Address - Street 1:50 MOUNT VERNON TER
Mailing Address - Street 2:
Mailing Address - City:LUDOWICI
Mailing Address - State:GA
Mailing Address - Zip Code:31316-0020
Mailing Address - Country:US
Mailing Address - Phone:912-261-2695
Mailing Address - Fax:
Practice Address - Street 1:462 ELMA G MILES PKWY
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4000
Practice Address - Country:US
Practice Address - Phone:912-369-9457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7123227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty