Provider Demographics
NPI:1740374875
Name:MIKE PERL M. D. P. A.
Entity type:Organization
Organization Name:MIKE PERL M. D. P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:PERL
Authorized Official - Suffix:SR
Authorized Official - Credentials:M D
Authorized Official - Phone:954-562-5907
Mailing Address - Street 1:2855 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1405
Mailing Address - Country:US
Mailing Address - Phone:954-562-5907
Mailing Address - Fax:
Practice Address - Street 1:2855 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1405
Practice Address - Country:US
Practice Address - Phone:954-562-5907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48608174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty