MEDICARE: MICHAEL CLYDE PALAFOX APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11045675	FL
2	2084P0800X	Psychiatry Physician	APRN11045675	OH
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	4056124	KY

General Provider Information

NPI Number	:	1194670604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CLYDE PALAFOX APRN

Provider Business Mailing Address
First Line	:	1148 STANTON SHADOW LN
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-5485
Country	:	US
Telephone Number	:	407-493-3144
Fax Number	:

Provider Business Practice Location Address
First Line	:	1148 STANTON SHADOW LN
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-5485
Country	:	US
Telephone Number	:	407-493-3144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	06/09/2026

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