Provider Demographics
NPI:1831165042
Name:PALMA, AXELL FRANCISCO (MD)
Entity type:Individual
Prefix:MR
First Name:AXELL
Middle Name:FRANCISCO
Last Name:PALMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 SW 108TH AVE APT B316
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8637
Mailing Address - Country:US
Mailing Address - Phone:786-355-9576
Mailing Address - Fax:
Practice Address - Street 1:13335 SW 124TH ST STE 212
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7515
Practice Address - Country:US
Practice Address - Phone:305-433-2488
Practice Address - Fax:786-732-0460
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073848208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL104668200Medicaid
FL5902-0000418890OtherBC/BS
FLBP4577815OtherDEA
FL41889Medicare PIN
FL5902-0000418890OtherBC/BS