MEDICARE: DREW A PALMER M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program	247721	MA
2	208800000X	Urology Physician	ME134811	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME134811	OTHER	FL	STATE OF FLORIDA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174818710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DREW A PALMER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 26026
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33623-6026
Country	:	US
Telephone Number	:	813-356-0196
Fax Number	:	813-356-0197

Provider Business Practice Location Address
First Line	:	2708 W SAINT ISABEL ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6320
Country	:	US
Telephone Number	:	813-877-7434
Fax Number	:

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

Provider Enumeration Date	:	06/11/2011
Last Update Date	:	10/03/2022

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