Provider Demographics
NPI:1164419172
Name:PALM ORTHOPEDICS, INC
Entity Type:Organization
Organization Name:PALM ORTHOPEDICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPO, RPH
Authorized Official - Phone:239-262-2797
Mailing Address - Street 1:883 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5733
Mailing Address - Country:US
Mailing Address - Phone:239-262-2797
Mailing Address - Fax:239-262-8663
Practice Address - Street 1:883 4TH AVE N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5733
Practice Address - Country:US
Practice Address - Phone:239-262-2797
Practice Address - Fax:239-262-8663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPOR 27332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL202688OtherWELLCARE DME
FLM0564OtherBC/BS DME
FL0285460001Medicare NSC