Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | ME125598 | FL |
NPI | 1073765574 |
---|---|
Provider Name | Dr. Emmanouil Palaios |
First Address | Weston, FL 33331-3609 |
Second Address | Weston, FL 33331-3625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2008 |
Last Update Date | 03/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
019086700 | (05) | FL |