Provider Demographics
NPI:1558517656
Name:MICHAEL WILLIAM PERRY MD PC
Entity Type:Organization
Organization Name:MICHAEL WILLIAM PERRY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-289-9613
Mailing Address - Street 1:3001 N ROCKY POINT DR E
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5810
Mailing Address - Country:US
Mailing Address - Phone:813-289-9613
Mailing Address - Fax:813-902-6342
Practice Address - Street 1:8700 E VISTA BONITA DR
Practice Address - Street 2:SUITE 240
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4251
Practice Address - Country:US
Practice Address - Phone:813-289-9613
Practice Address - Fax:813-902-6342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55550174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty