Provider Demographics
NPI:1295497006
Name:PALACIOS PEREZ, JESUS ANTONIO (APRN)
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:ANTONIO
Last Name:PALACIOS PEREZ
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 S CONGRESS AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7652
Mailing Address - Country:US
Mailing Address - Phone:561-433-5577
Mailing Address - Fax:561-275-2696
Practice Address - Street 1:2326 S CONGRESS AVE STE 1A
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-7652
Practice Address - Country:US
Practice Address - Phone:561-433-5577
Practice Address - Fax:561-275-2696
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11041269363LF0000X
FLHSE322812081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine