Provider Demographics
NPI:1083726400
Name:PALANIAPPAN, JAWAHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAWAHAR
Middle Name:
Last Name:PALANIAPPAN
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 1:3345 BURNS RD STE 105
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4304
Mailing Address - Country:US
Mailing Address - Phone:561-626-1881
Mailing Address - Fax:561-721-8605
Practice Address - Street 1:4915 SOUTH CONGRESS AVE
Practice Address - Street 2:STE B & C
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-3346
Practice Address - Country:US
Practice Address - Phone:561-967-1046
Practice Address - Fax:561-967-0167
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.045420207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
060012853OtherRAILROAD MEDICARE
OH049558Medicaid
OHPA0518187Medicare Oscar/Certification
A80433Medicare UPIN
OHPA0518187Medicare PIN