Provider Demographics
NPI:1063591329
Name:PERLMAN, RANDI GAIL (CNM)
Entity type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:GAIL
Last Name:PERLMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 CASPER CT
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2414
Mailing Address - Country:US
Mailing Address - Phone:954-966-0961
Mailing Address - Fax:
Practice Address - Street 1:JACKSON MEMORIAL HOSPITAL
Practice Address - Street 2:1611 NW 12 AVE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-585-5116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0955132367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9514ZMedicare ID - Type Unspecified