Healthcare Provider Details

I. General information

NPI: 1194670604
Provider Name (Legal Business Name): MICHAEL CLYDE PALAFOX APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1148 STANTON SHADOW LN
APOPKA FL
32712-5485
US

IV. Provider business mailing address

1148 STANTON SHADOW LN
APOPKA FL
32712-5485
US

V. Phone/Fax

Practice location:
  • Phone: 407-493-3144
  • Fax:
Mailing address:
  • Phone: 407-493-3144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11045675
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: