Basic Information
| Provider Information | |||||||||
| NPI: | 1629062245 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POLLAK | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1745 N MILLS AVE | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078417151 | ||||||||
| FaxNumber: | 4076482259 | ||||||||
| Practice Location | |||||||||
| Address1: | 1745 N MILLS AVE | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078417151 | ||||||||
| FaxNumber: | 4076482259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2005 | ||||||||
| LastUpdateDate: | 06/29/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0001X | ME50582 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | 207RC0000X | ME50582 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | ME50582 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.