Organization
PALMER MOBILE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL COPELAND PALMER APRN (MANAGING MEMBER)
(330) 415-4473
Entity
Organization
Contact information
Practice address
10146 SALT AIRE CIR, VENICE, FL 34292-2282
(330) 415-4473
Mailing address
10146 SALT AIRE CIR, VENICE, FL 34292-2282
(330) 415-4473
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/20/2020
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