Basic Information
Provider Information
NPI: 1720061500
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PALMA
FirstName: ERICK
MiddleName: ABDIEL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 15680 N KENDALL DR
Address2: SUITE 201
City: MIAMI
State: FL
PostalCode: 331961159
CountryCode: US
TelephoneNumber: 3054369933
FaxNumber: 3055002137
Practice Location
Address1: 7000 SW 62ND AVE
Address2: SUITE 201
City: SOUTH MIAMI
State: FL
PostalCode: 331434716
CountryCode: US
TelephoneNumber: 3056619404
FaxNumber: 3056611510
Other Information
ProviderEnumerationDate: 11/25/2005
LastUpdateDate: 01/11/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XME93119FLY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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