Provider Demographics
NPI:1932116233
Name:PERLSTEIN, WILLIAM M (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:PERLSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:MICHAEL
Other - Last Name:PERLSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-6139
Mailing Address - Fax:352-273-6156
Practice Address - Street 1:1600 SW ARCHER ROAD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0371
Practice Address - Country:US
Practice Address - Phone:352-273-6139
Practice Address - Fax:352-273-6156
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6264103T00000X
FLPY6294103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54652YMedicare PIN