| Doctor Name: | ELIE M POLISSAINT |
| NPI Number: | 1053341412 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARRT |
| License Number: | 62331 |
| Business Practice Address: | 3630 William St Lake Park, FL - 334031634 |
| Business Phone Number: | 5612827672 |
| Business Fax Number: | 5616831932 |
| Mailing Address: | 8190 Okeechobee Blvd, WELLINGTON |
| State: | FL |
| Postal Code: | 334112047 |
| Phone Number: | 5612827672 |
| Fax Number: | 5616835787 |
| NPI Enumeration Date: | 07/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471C3401X |
| License Number: | 62331 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Computed Tomography |
| Taxonomy Definition: | |