Provider Demographics
NPI:1306934500
Name:DY, FLOCERFINA PALAMOS (PT)
Entity type:Individual
Prefix:MRS
First Name:FLOCERFINA
Middle Name:PALAMOS
Last Name:DY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 FIELDCREST CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-7082
Mailing Address - Country:US
Mailing Address - Phone:615-300-9589
Mailing Address - Fax:615-824-5971
Practice Address - Street 1:102 FIELDCREST CIR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-7082
Practice Address - Country:US
Practice Address - Phone:615-300-9589
Practice Address - Fax:615-824-5971
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3686678Medicare PIN
Q34016Medicare UPIN