Doctor Name: | DR. JESSE IRA PALMER |
NPI Number: | 1245566991 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME 89023 |
Business Practice Address: | 1621 Gulf Blvd Apt 501 Clearwater, FL - 337672905 |
Business Phone Number: | 7275174493 |
Business Fax Number: | |
Mailing Address: | 1621 Gulf Blvd Apt 501, CLEARWATER |
State: | FL |
Postal Code: | 337672905 |
Phone Number: | 7275174493 |
Fax Number: | |
NPI Enumeration Date: | 10/29/2009 |
NPI Last Update Date: | 10/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME 89023 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |