Provider Demographics
NPI:1083683122
Name:PEARL, ROBERT J (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:PEARL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1725 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6089
Mailing Address - Country:US
Mailing Address - Phone:954-755-1300
Mailing Address - Fax:954-755-7799
Practice Address - Street 1:1725 N UNIVERSITY DR
Practice Address - Street 2:SUITE 440
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6089
Practice Address - Country:US
Practice Address - Phone:954-755-1300
Practice Address - Fax:954-755-7799
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS10079207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOD41545Medicare UPIN