Provider Demographics
NPI:1659029825
Name:PERUGORRIA MD PA
Entity Type:Organization
Organization Name:PERUGORRIA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:YAMIRKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERUGORRIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:754-308-1760
Mailing Address - Street 1:7522 WILES RD STE B212
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2062
Mailing Address - Country:US
Mailing Address - Phone:754-308-1750
Mailing Address - Fax:
Practice Address - Street 1:7522 WILES RD STE B212
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2062
Practice Address - Country:US
Practice Address - Phone:754-308-1750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty