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Provider Information for 1386704856

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. EDUARDO P PALANCA MD

Gender: MALE

Individual NPI: 1386704856

Calendar   Last Updated:  2014-10-02
  Certification Date: 

Details

Name Value
NPI 1386704856
Enumeration Date 2006-12-12
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2719 STATE ROAD 580
CLEARWATER, FL 33761-3343
United States

Phone: 727-724-8777 | Fax: 727-797-5699
View Map External Link
Primary Practice Address 2719 STATE ROAD 580
CLEARWATER, FL 33761-3343
United States

Phone: 727-724-8777 | Fax: 727-797-5699
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID WI 34026300
Other BCBSF FL 149PN
MEDICAID FL 003086500
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207Q00000X - Family Medicine IL 036-106551
No 207Q00000X - Family Medicine FL ME 107758
No 207Q00000X - Family Medicine WI 42699