Provider Demographics
NPI:1255501516
Name:PERLMUTTER, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PERLMUTTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 GOODLETTE RD N
Mailing Address - Street 2:#270
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5400
Mailing Address - Country:US
Mailing Address - Phone:239-649-7400
Mailing Address - Fax:239-649-6370
Practice Address - Street 1:800 GOODLETTE RD N
Practice Address - Street 2:#270
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5400
Practice Address - Country:US
Practice Address - Phone:239-649-7400
Practice Address - Fax:239-649-6370
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME403792084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD61598Medicare UPIN