Provider Demographics
NPI:1831173566
Name:PERELMAN, MITCHELL ALAN (MD)
Entity type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:ALAN
Last Name:PERELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10817 S. JOG RD.
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BOYNTON BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33437
Mailing Address - Country:US
Mailing Address - Phone:561-634-8888
Mailing Address - Fax:561-634-8889
Practice Address - Street 1:10817 S. JOG ROAD
Practice Address - Street 2:SUITE 230
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437
Practice Address - Country:US
Practice Address - Phone:561-634-8888
Practice Address - Fax:561-634-8889
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2011-08-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0063015207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
18245Medicare ID - Type Unspecified
FLF32863Medicare UPIN
F32863Medicare UPIN