Provider Demographics
NPI:1376206805
Name:PERRYMAN, SIRENA (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:
First Name:SIRENA
Middle Name:
Last Name:PERRYMAN
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 FERNLEA DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-5427
Mailing Address - Country:US
Mailing Address - Phone:561-689-6894
Mailing Address - Fax:
Practice Address - Street 1:1141 FERNLEA DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-5427
Practice Address - Country:US
Practice Address - Phone:561-689-6894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL690807896Medicaid