Provider Demographics
NPI:1992045900
Name:AXELL F PALMA MD LLC
Entity Type:Organization
Organization Name:AXELL F PALMA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:AXELL
Authorized Official - Middle Name:F
Authorized Official - Last Name:PALMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-355-9576
Mailing Address - Street 1:7821 CORAL WAY
Mailing Address - Street 2:101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6542
Mailing Address - Country:US
Mailing Address - Phone:786-355-9576
Mailing Address - Fax:
Practice Address - Street 1:7821 CORAL WAY
Practice Address - Street 2:101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6542
Practice Address - Country:US
Practice Address - Phone:786-355-9576
Practice Address - Fax:305-261-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008-208-300Medicaid
FL5902-00004-18890OtherBLUE CROSS & BLUE SHIELD
FLBP 457 7815OtherDRUG ENFORCEMENT ADM.