Healthcare Provider Details

I. General information

NPI: 1134107857
Provider Name (Legal Business Name): ADRIAN PADUREAN PALMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ADRIAN MIRCEA PADUREAN M.D.

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 03/25/2020
Certification Date: 03/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12701 COMMONWEALTH DR SUITE 9
FORT MYERS FL
33913
US

IV. Provider business mailing address

12701 COMMONWEALTH DR SUITE 9
FORT MYERS FL
33913
US

V. Phone/Fax

Practice location:
  • Phone: 239-768-0600
  • Fax:
Mailing address:
  • Phone: 239-768-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number47298
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number47298
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: