Provider Demographics
NPI:1003452855
Name:POLATNICK, ARIANNE
Entity type:Individual
Prefix:
First Name:ARIANNE
Middle Name:
Last Name:POLATNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19101 MYSTIC POINTE DR APT 1509
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-4517
Mailing Address - Country:US
Mailing Address - Phone:215-279-3434
Mailing Address - Fax:
Practice Address - Street 1:19101 MYSTIC POINTE DR APT 1509
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-4517
Practice Address - Country:US
Practice Address - Phone:215-279-3434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0282332251P0200X
FLPT354722251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics