Palm Medical, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PALM MEDICAL, LLC

Practice address

777 E 25TH St Ste 306
Hialeah, FL 33013-3849

Phone

(305) 760-9760

NPI assigned

Feb 11, 2020

Last updated

Feb 11, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Trevor Felicetti

Title

Owner

Phone

(212) 297-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1689206393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 306",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E 25TH ST STE 306",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330133849",
            "telephone_number": "305-760-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "FELICETTI",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-297-2000"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "HCC12013",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "palm.medical@revprohealthcare.com",
            "affiliation": "N",
            "address_1": "777 E 25th St Ste 306",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330133849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Palm Lake Medical Center Inc
• Palm Lakes Pharmacy, Inc.
• Palm Medical Center Hialeah, LLC
• Palm Medical Institute
• Palm Medical West, LLC
• Palm Pharmacy
• Palm Pharmacy & Discount Store Inc (Sedanos Pharmacy #6)
• Palm Plaza Medical Center, LLC
• Palm Primary Care, LLC
• Palm Rehab Center

• Chiropractor in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.