Healthcare Provider Details

I. General information

NPI: 1386145381
Provider Name (Legal Business Name): MARILYN PALMER FNP-C, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2018
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

PO BOX 198054
ATLANTA GA
30384-8054
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-7067
  • Fax:
Mailing address:
  • Phone: 786-596-7067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9284856
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9284856
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: