Healthcare Provider Details

I. General information

NPI: 1972529584
Provider Name (Legal Business Name): PALAM ANNAMALAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PALAM ANNAMALAI MD

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 14TH ST STE 702
MIAMI FL
33136-2118
US

IV. Provider business mailing address

3205 SALISBURY CT
FRIENDSWOOD TX
77546-2532
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6732
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number4301118907
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number35.136651
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301118907
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD467367
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.136651
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberL6765
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number52523
License Number StateKY
# 8
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number52523
License Number StateKY
# 9
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberL6765
License Number StateTX
# 10
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number0101267605
License Number StateVA
# 11
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101267605
License Number StateVA
# 12
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD467367
License Number StatePA
# 13
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number330930
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: