Provider Demographics
NPI:1497973499
Name:PALMIERI, BERTHA
Entity Type:Individual
Prefix:
First Name:BERTHA
Middle Name:
Last Name:PALMIERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SW 107AVE.
Mailing Address - Street 2:15
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174
Mailing Address - Country:US
Mailing Address - Phone:305-220-9700
Mailing Address - Fax:305-544-6088
Practice Address - Street 1:15 SW 107AVE.
Practice Address - Street 2:15
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3317
Practice Address - Country:US
Practice Address - Phone:305-220-9700
Practice Address - Fax:305-544-6088
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health