Provider Demographics
NPI:1801839915
Name:POLHILL, RICHARD (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:POLHILL
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 CLYDE MORRIS BLVD.
Mailing Address - Street 2:STE B
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129
Mailing Address - Country:US
Mailing Address - Phone:386-265-4769
Mailing Address - Fax:
Practice Address - Street 1:4550 CLYDE MORRIS BLVD.
Practice Address - Street 2:STE B
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129
Practice Address - Country:US
Practice Address - Phone:386-265-4769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS2602237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist