| Organization Name: | POLK CORRECTIONAL INSTITUTION |
| NPI Number: | 1679810972 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LONG N DO (CHIEF HEALTH OFFICER) |
| Mailing Address: | 10800 Evans Rd Polk City |
| State: | FL US |
| Postal Code: | 338686925 |
| Phone Number: | 8639842273 |
| Fax Number: | 8639841021 |
| NPI Enumeration Date: | 01/08/2013 |
| NPI Last Update Date: | 01/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | PA9100731 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |