| Doctor Name: | WANDA I POLANCO |
| NPI Number: | 1053434183 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 26761 |
| Business Practice Address: | Anexo Hospital Buen Sasmaritano Centro De Metadona De Aguadilla Aguadilla, PR - 006054056 |
| Business Phone Number: | 7878912360 |
| Business Fax Number: | |
| Mailing Address: | Po Box 4056, AGUADILLA |
| State: | PR |
| Postal Code: | 006054056 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA0400X |
| License Number: | 26761 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |