Provider Demographics
NPI:1962507863
Name:PALERMO, GIUSEPPE (MD)
Entity Type:Individual
Prefix:
First Name:GIUSEPPE
Middle Name:
Last Name:PALERMO
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:PO BOX 534595
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-4595
Mailing Address - Country:US
Mailing Address - Phone:321-636-2111
Mailing Address - Fax:321-636-9219
Practice Address - Street 1:107 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2827
Practice Address - Country:US
Practice Address - Phone:321-636-2111
Practice Address - Fax:321-636-9219
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL64498207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00708079OtherRR MEDICARE
FL373833700Medicaid
FLP00708079OtherRR MEDICARE
FLF69005Medicare UPIN
FL23484Medicare PIN