Healthcare Provider Details

I. General information

NPI: 1962924191
Provider Name (Legal Business Name): PALMERS MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5413 N STATE RD
TAMARAC FL
33319
US

IV. Provider business mailing address

5413 N STATE RD
TAMARAC FL
33319
US

V. Phone/Fax

Practice location:
  • Phone: 954-526-9477
  • Fax: 954-530-6843
Mailing address:
  • Phone: 954-526-9477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. JEAN ROBERT CHARLOT
Title or Position: OWNER
Credential: MD
Phone: 954-526-9477