Provider Demographics
NPI:1548221237
Name:PERLOFF, DAVID EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:EDWARD
Last Name:PERLOFF
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 1:2307 W BROWARD BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-1420
Mailing Address - Country:US
Mailing Address - Phone:954-523-3422
Mailing Address - Fax:954-523-3423
Practice Address - Street 1:2307 W BROWARD BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-1420
Practice Address - Country:US
Practice Address - Phone:954-523-3422
Practice Address - Fax:954-523-3423
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63534207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255353800Medicaid
FL18618AMedicare ID - Type Unspecified
FL255353800Medicaid