| Organization Name: | P3 MEDICAL, INC. |
| NPI Number: | 1093193906 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATTY POLLEY (PRESIDENT) |
| Mailing Address: | 2505 Northumbria Dr Sanford |
| State: | FL US |
| Postal Code: | 327716494 |
| Phone Number: | 4073617565 |
| Fax Number: | 8555523776 |
| NPI Enumeration Date: | 05/12/2015 |
| NPI Last Update Date: | 05/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 164W00000X |
| License Number: | PN680621 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Licensed Practical Nurse |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |