Provider Demographics
NPI:1518926690
Name:PERSZYK, ANTHONY ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ANDREW
Last Name:PERSZYK
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 1:112 BARTRAM OAKS WALK UNIT 600849
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32260-7734
Mailing Address - Country:US
Mailing Address - Phone:904-673-0044
Mailing Address - Fax:904-673-1064
Practice Address - Street 1:1110 A1A N STE 101
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-4071
Practice Address - Country:US
Practice Address - Phone:904-673-0044
Practice Address - Fax:904-673-1064
Is Sole Proprietor?:No
Enumeration Date:2006-03-19
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64460208000000X, 207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3740552-00Medicaid
GA000570424BMedicaid
FL370020435OtherRAILROAD MEDICARE
FL23665YMedicare PIN
FL3740552-00Medicaid