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General NPI Number Information
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NPI Number | 1194734954
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Entity Type | Individual
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Provider Name | RAFAEL ARMANDO PALACIOS PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 1431 SW 1ST AVE OCALA REGIONAL MEDICAL CENTER, DPMT OF EMERGENCY MED
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City | OCALA
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State | FL
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Zip | 34471
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Country | US
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Telephone | 352-351-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 2412 SE 27TH ST
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City | OCALA
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State | FL
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Zip | 34471-0703
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Country | US
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Telephone | 352-867-7116
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Fax | 352-867-7116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9103290
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 04573
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License Number State | TX
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