Provider Demographics
NPI:1467660647
Name:PALM ORTHOPAEDIC INSTITUTE INC
Entity Type:Organization
Organization Name:PALM ORTHOPAEDIC INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-434-6796
Mailing Address - Street 1:1501 FOREST HILL BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-6081
Mailing Address - Country:US
Mailing Address - Phone:561-434-6796
Mailing Address - Fax:
Practice Address - Street 1:1501 FOREST HILL BLVD
Practice Address - Street 2:STE 101
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-6081
Practice Address - Country:US
Practice Address - Phone:561-434-6796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-19
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85744207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5389060001Medicare NSC
FL51959Medicare PIN
FLH72537Medicare UPIN