Healthcare Provider Details

I. General information

NPI: 1588918932
Provider Name (Legal Business Name): DANNY J PALMER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21110 BISCAYNE BLVD SUITE 203
AVENTURA FL
33180-1227
US

IV. Provider business mailing address

PO BOX 69
JUPITER FL
33468-0069
US

V. Phone/Fax

Practice location:
  • Phone: 305-948-9595
  • Fax: 305-948-9292
Mailing address:
  • Phone: 561-932-0995
  • Fax: 561-932-0997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA 9106811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: