Provider Demographics
NPI:1245275643
Name:POLITO, JANET
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:
Last Name:POLITO
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 1:2500 QUANTUM LAKES DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8324
Mailing Address - Country:US
Mailing Address - Phone:561-244-3643
Mailing Address - Fax:
Practice Address - Street 1:3200 BAILEY LN
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-8522
Practice Address - Country:US
Practice Address - Phone:239-436-3569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6116207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9I2N8OtherBCBS
FLP00065086OtherRAILROAD MEDICARE
FL115565000Medicaid