Provider Demographics
NPI:1881655157
Name:PALMER, DEAN (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5431 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4639
Mailing Address - Country:US
Mailing Address - Phone:954-344-2522
Mailing Address - Fax:954-344-9189
Practice Address - Street 1:18503 PINES BLVD
Practice Address - Street 2:SUITE 311
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1404
Practice Address - Country:US
Practice Address - Phone:954-499-2505
Practice Address - Fax:866-829-6209
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89898207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270336000Medicaid
FLH48695Medicare UPIN
37879WMedicare PIN