ETHAN G POLSKY (NPI# 1871559740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871559740 |
| Entity Type | Individual |
| Full Name | ETHAN G POLSKY |
| Credential | M.D. |
| Practice Address |
4712 N Armenia Ave Suite 200 Tampa FL 33603-2611 |
| Practice Telephone | 8138747500 |
| Practice Fax Number | 8138771397 |
| Mailing Telephone | 8138747500 |
| Mailing Fax Number | 8138771397 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2015-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
ME95516 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 275204200 | 05 |
| Street Address |
4712 N ARMENIA AVE SUITE 200 |
| City | TAMPA |
| State | FL |
| Zip Code | 33603-2611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407842701 | Mark E Kolligian | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2005-09-22 |
| 1609118389 | Kristine Budd Rietsma | Pediatrics | 4712 N Armenia Ave, Suite 102, Tampa, FL 33603-2611 | 2013-03-20 |
| 1962631994 | Katherine Corbyons | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2009-07-13 |
| 1942462619 | Sisir Botta | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2008-06-25 |
| 1003080722 | Bay Central Medical Group | Family Medicine | 4712 N Armenia Ave, Suite 102, Tampa, FL 33603-2611 | 2008-04-14 |
| 1902936248 | C. Edgar Davila Dds Ms Pa | Dentist | 4712 N Armenia Ave, Suite 100, Tampa, FL 33603-2611 | 2007-03-06 |
| 1093885709 | Christina Joy Canody | Pediatrics | 4712 N Armenia Ave, Suite 102, Tampa, FL 33603-2611 | 2006-11-09 |
| 1346348166 | Christian Edgar Davila | Dentist | 4712 N Armenia Ave, Suite 100, Tampa, FL 33603-2611 | 2006-09-20 |
| 1194836239 | Childrens Urology Group Pl | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2006-08-31 |
| 1114913423 | Elliot Michael Reisman | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2005-09-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700400959 | Jean V. Dieudonne | Pharmacist | 701 W. Dr Martin Luther King Blvd, Tampa, FL 33603 | 2020-06-03 |
| 1538791082 | Champion Wellness Center of The Heights | Chiropractor | 800 W Martin Luther King Jr Blvd, Suite 3, Tampa, FL 33603 | 2020-02-12 |
| 1700366010 | Marie A Brister Md LLC | Family Medicine | 508 W Dr Martin Luther King Jr Blvd Ste A, Tampa, FL 33603 | 2018-08-16 |
| 1619415197 | Riverside Recovery of Tampa, LLC | Substance Abuse Rehabilitation Facility | 4004 N. Riverside Dr., Tampa, FL 33603 | 2017-02-06 |
| 1306213194 | Jacqueline Dowgiallo | Case Manager/Care Coordinator | 4004 N Riverside Dr, Tampa, FL 33603 | 2015-08-27 |
| 1629487061 | Robin Ann Waters | Social Worker | 1016 W Hillsborough Ave, Tampa, FL 33603 | 2014-08-11 |
| 1831430453 | Cassandra Gonzalez | Social Worker | 1726 W Rio Vista Ave, Tampa, FL 33603 | 2013-03-06 |
| 1487908893 | Spine Injury Physicians LLC | Neurological Surgery | 607 W Martin Luther King Blvd, Suite 1, Tampa, FL 33603 | 2012-11-07 |
| 1861742124 | Joseph Timothy Candelore Jr. | Internal Medicine | 2333 W Hillsborough Ave Ste 160, Tampa, FL 33603 | 2012-09-14 |
| 1679835599 | Odessa Biandudi | Dentist | 825 West Martin Luther King Boulevard, Tampa, FL 33603 | 2012-06-15 |
| Find all providers in zip 33603 | ||||
| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407842701 | Mark E Kolligian | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2005-09-22 |
| 1962631994 | Katherine Corbyons | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2009-07-13 |
| 1942462619 | Sisir Botta | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2008-06-25 |
| 1194836239 | Childrens Urology Group Pl | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2006-08-31 |
| 1114913423 | Elliot Michael Reisman | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2005-09-22 |
| 1356337653 | Dennis L. Hoover | Urology | 4712 N Armenia Ave, Ste. 200, Tampa, FL 33603-2611 | 2005-09-22 |
| 1386630697 | Yves L Homsy | Urology | 4712 N Armenia Ave, Suite 200, Tampa, FL 33603-2611 | 2005-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053357913 | Andrew S Labbie | Urology | 3200 Sw 60th Ct Ste 104, Miami, FL 33155-4069 | 2006-06-21 |
| 1295277911 | Florida Urology Specialists LLC | Urology | 1 S School Ave, Suite 200, Sarasota, FL 34237-6014 | 2016-11-11 |
| 1225438666 | Mariarita Salvitti | Urology | 3200 Sw 60th Ct, Suite 104, Miami, FL 33155-4000 | 2014-09-03 |
| 1851717151 | Alireza Alam | Urology | 3200 Sw 60th Ct Ste 104, Miami, FL 33155-4069 | 2014-03-11 |
| 1659718989 | George Ransford | Urology | 3100 Sw 62nd Ave, Miami, FL 33155 | 2013-05-28 |
| 1376834820 | Diana Cardona-grau | Urology | 1725 Cook Ave, Orlando, FL 32806-2911 | 2011-05-02 |
| 1487951554 | Natalia Ballesteros | Urology | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2011-02-24 |
| 1588965909 | Karl Sturge M.d. P.a. | Urology | 9299 Sw 152nd Street, Suite 205, Miami, FL 33157 | 2010-11-17 |
| 1295049138 | John P Adams Md Pa | Urology | 200 Doctors Dr, Panama City, FL 32405-4559 | 2010-08-03 |
| 1396060596 | Kristin Ann Kozakowski | Urology | 3200 Sw 60th Ct Ste 104, Miami, FL 33155-4069 | 2010-03-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.