Provider Demographics
NPI:1770660151
Name:PERKINS, GENE A JR (D C)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:A
Last Name:PERKINS
Suffix:JR
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 NE 26TH AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1147
Mailing Address - Country:US
Mailing Address - Phone:954-946-3703
Mailing Address - Fax:954-943-2280
Practice Address - Street 1:2323 NE 26TH AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1147
Practice Address - Country:US
Practice Address - Phone:954-946-3703
Practice Address - Fax:954-943-2280
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007854111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381743100Medicaid
FL51835OtherBLUE CROSS BLUE SHIELD
FL51835OtherBLUE CROSS BLUE SHIELD
FL51835ZMedicare ID - Type Unspecified