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NPI Code Detail

MEDICARE: FAMILY HEALTHSERVICES MINNESOTA, P.A.

MEDICARE: FAMILY HEALTHSERVICES MINNESOTA, P.A.
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
12081S0010XSports Medicine (Physical Medicine & Rehabilitation) Physician
2207Q00000XFamily Medicine Physician1428MN

General Provider Information

NPI Number : 1528248259
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY HEALTHSERVICES MINNESOTA, P.A.
Provider Business Mailing Address
First Line : 2025 SLOAN PL STE 35
Second Line :
City : SAINT PAUL
State : MN
Zip : 55117-2092
Country : US
Telephone Number : 651-772-1572
Fax Number : 651-772-1889
Provider Business Practice Location Address
First Line : 3550 LABORE RD STE 7
Second Line :
City : VADNAIS HEIGHTS
State : MN
Zip : 55110-5113
Country : US
Telephone Number : 651-788-4444
Fax Number : 651-766-9451
Authorized Official
Title or Position : CAO
Name : KEN PALATTO
Credential :
Telephone Number : 651-772-1572
Provider Enumeration Date : 11/09/2007
Last Update Date : 10/14/2025

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