Provider Demographics
NPI:1881815447
Name:PERRUCI, VALERIA R (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIA
Middle Name:R
Last Name:PERRUCI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29750 US HIGHWAY 19 N STE 101
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-1510
Mailing Address - Country:US
Mailing Address - Phone:727-786-5058
Mailing Address - Fax:813-635-2639
Practice Address - Street 1:29750 US HIGHWAY 19 N STE 101
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1510
Practice Address - Country:US
Practice Address - Phone:727-786-5058
Practice Address - Fax:813-635-2639
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99793207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280336400Medicaid
FLP00473555OtherRAILROAD MEDICARE PROVIDER NUMBER
FLAG008YMedicare PIN