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Individual

MARK R PALAZZOLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1160 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
(407) 518-1074
Mailing address
502 GOLFPARK DR, CELEBRATION, FL 34747-4626
(586) 801-8980

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
OS10224
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200000002505
PHP
MI
05
281269000
FL
05
4505156
MI
01
AS941Y
MEDICARE
FL
01
P00014737
RAILROAD MEDICARE
MI
Enumeration date
07/17/2006
Last updated
07/16/2014
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