Provider Demographics
NPI:1790959690
Name:PERLMAN, MOLLY MCSHANE (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:MCSHANE
Last Name:PERLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:MOLLY
Other - Last Name:MCSHANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6100 SW 76TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5002
Mailing Address - Country:US
Mailing Address - Phone:305-663-1876
Mailing Address - Fax:
Practice Address - Street 1:6100 SW 76TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5002
Practice Address - Country:US
Practice Address - Phone:305-663-1876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME01099482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME0109948OtherSTATE MEDICAL LICENSE
ORMD185064OtherSTATE MEDICAL LICENSE
NY291485OtherSTATE MEDICAL LICENSE
MDD0086897OtherSTATE MEDICAL LICENSE
TXS2417OtherSTATE MEDICAL LICENSE
VA0101265338OtherSTATE MEDICAL LICENSE
IL036.151530OtherSTATE MEDICAL LICENSE
MA273226OtherSTATE MEDICAL LICENSE
LA321667OtherSTATE MEDICAL LICENSE
CAC153230OtherSTATE MEDICAL LICENSE
PAMD462761OtherSTATE MEDICAL LICENSE