Individual
GUILLERMO A PALACIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 987-2000
(954) 437-6628
Mailing address
1499 WALTON WAY, SUITE 1400, ATTN: DONNA RAIFORD, AUGUSTA, GA 30901-2660
(706) 828-8401
(706) 722-7235
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME99650
FL
2085R0205X
Radiological Physics Physician
Primary
067073
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067073
MEDICAL LICENSE
GA
Enumeration date
06/14/2006
Last updated
09/27/2017
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