Healthcare Provider Details

I. General information

NPI: 1477063618
Provider Name (Legal Business Name): SHOLEM MICHAEL PALEVSKY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N FEDERAL HWY STE 104
POMPANO BEACH FL
33062-1011
US

IV. Provider business mailing address

1800 N FEDERAL HWY STE 104
POMPANO BEACH FL
33062-1011
US

V. Phone/Fax

Practice location:
  • Phone: 954-782-0010
  • Fax: 954-781-2139
Mailing address:
  • Phone: 954-782-0010
  • Fax: 954-781-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS14910
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberOS14910
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: