MEDICARE: MR. MICHAEL EVERETT PALMER II PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013253095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL EVERETT PALMER II PA-C

Provider Business Mailing Address
First Line	:	144 PALMER SAWMILL RD
Second Line	:
City	:	CRESCENT CITY
State	:	FL
Zip	:	32112-5000
Country	:	US
Telephone Number	:	386-546-1331
Fax Number	:

Provider Business Practice Location Address
First Line	:	424 N PARK AVE
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-4152
Country	:	US
Telephone Number	:	407-886-0611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2012
Last Update Date	:	12/20/2012

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