Provider Demographics
NPI:1295337244
Name:PALACIOS, HELEN (OD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:PALACIOS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6921 CYPRESS RD APT A22
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2305
Mailing Address - Country:US
Mailing Address - Phone:786-873-0545
Mailing Address - Fax:
Practice Address - Street 1:18090 COLLINS AVE # T-13
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-1917
Practice Address - Country:US
Practice Address - Phone:305-974-0018
Practice Address - Fax:305-250-2722
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5886152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist