Provider Demographics
NPI:1821087180
Name:PERLSTEIN, LEON PERRY (DPM)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:PERRY
Last Name:PERLSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2520 MARINA BAY DR E
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-2320
Mailing Address - Country:US
Mailing Address - Phone:786-315-1111
Mailing Address - Fax:754-200-6057
Practice Address - Street 1:5961 NW 61ST AVE APT 101
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-2217
Practice Address - Country:US
Practice Address - Phone:754-666-3338
Practice Address - Fax:754-200-6057
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3054213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15280200Medicaid
FLU1779XMedicare PIN
FLU1779YMedicare PIN