Provider Demographics
NPI:1376727461
Name:PERLSTEIN, MITCHELL NEIL (MD)
Entity Type:Individual
Prefix:
First Name:MITCHELL
Middle Name:NEIL
Last Name:PERLSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 MATTOCKS CT
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-3429
Mailing Address - Country:US
Mailing Address - Phone:407-699-8875
Mailing Address - Fax:407-699-8875
Practice Address - Street 1:824 MATTOCKS CT
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-3429
Practice Address - Country:US
Practice Address - Phone:407-699-8875
Practice Address - Fax:407-699-8875
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 35558207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL47449OtherBLUE CROSS / BLUE SHIELD
FL890-03876OtherWORKMAN'S COMP
FLD55063Medicare UPIN
FL47449Medicare PIN