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General NPI Number Information
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NPI Number | 1669146668
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Entity Type | Individual
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Provider Name | MARISSA PALERMO APRN
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Gender | Female
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 603 N FLAMINGO RD STE 150
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1022
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Country | US
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Telephone | 954-436-6660
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Fax |
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Provider Business Mailing Address
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Address Line | 603 N FLAMINGO RD STE 150
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1022
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Country | US
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Telephone | 954-436-6600
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | APRN11014660
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License Number State | FL
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