Provider Demographics
NPI:1588918932
Name:PALMER, DANNY J (PA)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:J
Last Name:PALMER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-0069
Mailing Address - Country:US
Mailing Address - Phone:561-932-0995
Mailing Address - Fax:561-932-0997
Practice Address - Street 1:21110 BISCAYNE BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1227
Practice Address - Country:US
Practice Address - Phone:305-948-9595
Practice Address - Fax:305-948-9292
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9106811363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9106811OtherMEDICAL LICENSE