MEDICARE: PALUMBO WELLNESS LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1295605996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALUMBO WELLNESS LLC

Provider Business Mailing Address
First Line	:	2445 COUNTRY PLACE BLVD STE 101
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2445 COUNTRY PLACE BLVD STE 101
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-1102
Country	:	US
Telephone Number	:	727-420-6986
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	NICOLE ILENE BALKCOM
Credential	:	RN
Telephone Number	:	727-953-3599

Provider Enumeration Date	:	11/07/2025
Last Update Date	:	11/07/2025

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Directions to “PALUMBO WELLNESS LLC ” Practice Location

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