Provider Demographics
NPI:1518257666
Name:PERRY, JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:PERRY
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 1:33 E CAMINO REAL
Mailing Address - Street 2:APT 331
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-6149
Mailing Address - Country:US
Mailing Address - Phone:954-547-0088
Mailing Address - Fax:
Practice Address - Street 1:3313 W HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-9423
Practice Address - Country:US
Practice Address - Phone:954-571-9500
Practice Address - Fax:954-571-9560
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124182207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine