Provider Demographics
NPI:1467444067
Name:PERLA, LESLIE H (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:H
Last Name:PERLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1157 S STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6101
Mailing Address - Country:US
Mailing Address - Phone:561-214-6695
Mailing Address - Fax:561-753-7706
Practice Address - Street 1:1157 S STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6101
Practice Address - Country:US
Practice Address - Phone:561-214-6695
Practice Address - Fax:617-537-7065
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME98791207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278887000Medicaid
G22978Medicare UPIN
FL278887000Medicaid