MEDICARE: DR. CANDIDIO ROBERTO PALMA M,D.

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	174400000X	Specialist	ME 39072	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285622969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CANDIDIO ROBERTO PALMA M,D.

Provider Business Mailing Address
First Line	:	910 NE 26TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3607
Country	:	US
Telephone Number	:	954-565-8282
Fax Number	:	954-565-8994

Provider Business Practice Location Address
First Line	:	910 NE 26TH AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3607
Country	:	US
Telephone Number	:	954-565-8282
Fax Number	:	954-565-8994

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	07/08/2007

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