Polet, Jill Larue

Polet, Jill Larue is an individual health care provider with primary practice located at 8745 N Wickham Rd , Melbourne FL 32940-5997. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Polet, Jill Larue can be contacted via phone (321) 868-5871.

Contact Information

Primary practice address
8745 N Wickham Rd Melbourne FL 32940-5997
Phone: (321) 868-5871
Fax: (321) 434-9521
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APRN1804342 Florida

Profile Details

NPI number 1861550964
LBN Legal business name Polet, Jill Larue
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2006
Last updated Sep 18th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861550964 NPPES
Florida MEDICAID 112555300
Florida Other OL831

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