Provider Demographics
NPI:1912780792
Name:PERIU, HAMLET
Entity Type:Individual
Prefix:
First Name:HAMLET
Middle Name:
Last Name:PERIU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2977 GOODLETTE-FRANK RD N STE 40
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4615
Mailing Address - Country:US
Mailing Address - Phone:239-776-7987
Mailing Address - Fax:
Practice Address - Street 1:2977 GOODLETTE-FRANK RD N STE 40
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4615
Practice Address - Country:US
Practice Address - Phone:239-776-7987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13839225100000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261Q00000XOtherAMBULATORY HEALTH CARE