Provider Demographics
NPI:1063507176
Name:PERLER, ADAM D (DPM)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:D
Last Name:PERLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12416 66TH ST N
Mailing Address - Street 2:SUITE A
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-3430
Mailing Address - Country:US
Mailing Address - Phone:727-547-4700
Mailing Address - Fax:727-394-8661
Practice Address - Street 1:12416 66TH STREET N
Practice Address - Street 2:SUITE A
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-3437
Practice Address - Country:US
Practice Address - Phone:727-547-4700
Practice Address - Fax:727-394-8661
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000942213E00000X
FLPO3031213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200450000Medicaid
P00218596Medicare PIN
P00050974Medicare PIN
P00050972Medicare PIN
IN151560C8Medicare PIN
P00218596Medicare PIN
P00050972Medicare PIN