Healthcare Provider Details

I. General information

NPI: 1114192564
Provider Name (Legal Business Name): LINDA J PALMER DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 04/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 61ST WAY S A
BOYNTON BEACH FL
33437-2882
US

IV. Provider business mailing address

9850 61ST WAY S A
BOYNTON BEACH FL
33437-2882
US

V. Phone/Fax

Practice location:
  • Phone: 561-736-3383
  • Fax: 561-732-4662
Mailing address:
  • Phone: 561-736-3383
  • Fax: 561-732-4662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO2868
License Number StateFL

VIII. Authorized Official

Name: LINDA J PALMER
Title or Position: PRESIDENT
Credential: DPM
Phone: 561-736-3383