Basic Information
| Provider Information | |||||||||
| NPI: | 1891757126 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALMERI | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1936 32ND AVE. SPINE & JOINT TREATMENT CENTER | ||||||||
| Address2: | |||||||||
| City: | VERO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7727788882 | ||||||||
| FaxNumber: | 7727788894 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 45TH STREET | ||||||||
| Address2: | KIMMEL BLDG | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334072413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618445255 | ||||||||
| FaxNumber: | 5618445245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2006 | ||||||||
| LastUpdateDate: | 09/13/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA3266 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AS0400X | PA3266 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | X1624 | 01 | BCBS | OTHER | 290455100 | 05 | FL | MEDICAID | Y05FA | 01 | BCBS | OTHER | JP371 | 05 | FL | MEDICAID | MM303 | 05 | FL | MEDICAID |