Provider Demographics
NPI:1386863645
Name:PERLMAN, ADAM SCOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SCOTT
Last Name:PERLMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 NE 185TH ST
Mailing Address - Street 2:APT. #337
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3347
Mailing Address - Country:US
Mailing Address - Phone:954-695-6617
Mailing Address - Fax:
Practice Address - Street 1:1405 NW 107TH AVE
Practice Address - Street 2:DORAL INTERNATIONAL MALL
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2703
Practice Address - Country:US
Practice Address - Phone:305-594-6339
Practice Address - Fax:305-594-6249
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4049152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1902COtherBCBS OF FL
FL001063400Medicaid
FLBN774ZMedicare PIN