Individual
DR. ANOOP K PALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 HICKORY STREET, HOLMES REGIONAL MEDICAL CENTER, MELBOURNE, FL 32901
(321) 434-7208
(321) 434-5344
Mailing address
P.O. BOX 5720, PROVIDER ENROLLMENT DEPARTMENT, JACKSONVILLE, FL 32247-5720
(302) 651-4488
(407) 650-7578
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME98082
FL
208M00000X
Hospitalist Physician
Primary
ME98082
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02553
BLUE CROSS BLUE SHIELD OF FLORIDA
FL
05
—
278612500
—
FL
01
—
ME98082
FLORIDA MEDICAL DOCTOR LI
FL
Enumeration date
05/18/2007
Last updated
10/05/2011
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