Provider Demographics
NPI:1043607641
Name:PALACIOS, CARLA (DC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:PALACIOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 PRESIDENTIAL WAY APT 305
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1512
Mailing Address - Country:US
Mailing Address - Phone:646-543-2348
Mailing Address - Fax:
Practice Address - Street 1:2000 PRESIDENTIAL WAY APT 305
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1512
Practice Address - Country:US
Practice Address - Phone:646-543-2348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11471111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor