Provider Demographics
NPI:1629271184
Name:PALERMO, COROMOTO ANGELA (MD)
Entity Type:Individual
Prefix:MRS
First Name:COROMOTO
Middle Name:ANGELA
Last Name:PALERMO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:COROMOTO
Other - Middle Name:ANGELA
Other - Last Name:PALERMO GAROFALO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:680 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6738
Mailing Address - Country:US
Mailing Address - Phone:954-241-4084
Mailing Address - Fax:877-404-6043
Practice Address - Street 1:17751 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-3924
Practice Address - Country:US
Practice Address - Phone:954-241-4084
Practice Address - Fax:877-404-6043
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME125317207RE0101X, 207R00000X
PR17776207RE0101X, 207R00000X
PR26240207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine