Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | HSE32281 | FL |
NPI | 1295497006 |
---|---|
Provider Name | Jesus Palacios |
First Address | West Palm Beach, FL 33401-8739 |
Second Address | Lake Worth, FL 33461-6609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2021 |
Last Update Date | 08/10/2021 |