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General NPI Number Information
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NPI Number | 1114218914
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Entity Type | Organization
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Legal Business Name | PALM CO SERVICES, INC
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 700 OLD DIXIE HWY STE 105
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City | LAKE PARK
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State | FL
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Zip | 33403
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Country | US
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Telephone | 561-842-5298
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Fax | 561-842-5187
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Provider Business Mailing Address
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Address Line | 6891 CHURCH ST
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City | JUPITER
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State | FL
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Zip | 33458
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Country | US
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Telephone | 561-842-5298
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Fax | 561-842-5187
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Authorized Official
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Title or Position | OWNER
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Name | MISS KAREN ELIZABETH PALMER
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Credential | RDLDIN
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Telephone | 561-574-3990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | ND3435
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License Number State | FL
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