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NPI Code Detail

MEDICARE: MARK R PALAZZOLO DO

MEDICARE:   MARK R PALAZZOLO  DO
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
1207V00000XObstetrics & Gynecology PhysicianOS10224FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3AS941YOTHERFLMEDICARE
4P00014737OTHERMIRAILROAD MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1972520559
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK R PALAZZOLO DO
Provider Business Mailing Address
First Line : 502 GOLFPARK DR
Second Line :
City : CELEBRATION
State : FL
Zip : 34747-4626
Country : US
Telephone Number : 586-801-8980
Fax Number :
Provider Business Practice Location Address
First Line : 1160 CYPRESS GLEN CIR
Second Line :
City : KISSIMMEE
State : FL
Zip : 34741-7560
Country : US
Telephone Number : 407-518-1074
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 07/16/2014

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Directions to “ MARK R PALAZZOLO DO” Practice Location

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