Polles, Mark Benedict

Polles, Mark Benedict is an individual health care provider with primary practice located at 5637 Marine Pkwy , New Port Richey FL 34652-4316. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Polles, Mark Benedict can be contacted via phone (727) 848-1733.

Contact Information

Primary practice address
5637 Marine Pkwy New Port Richey FL 34652-4316
Phone: (727) 848-1733
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP95004120 California
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP2026672 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN-165625 Colorado

Profile Details

NPI number 1659402964
LBN Legal business name Polles, Mark Benedict
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2007
Last updated Sep 26th, 2017 - about 7 years ago

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 1659402964 NPPES
Minnesota MEDICAID 255456900
Minnesota Other 995N5PO
Minnesota MEDICAID 59031735

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