Provider Demographics
NPI:1124087556
Name:PERKINS, DANIEL B (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:PERKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 SW RUTLEDGE ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-1978
Mailing Address - Country:US
Mailing Address - Phone:850-973-8851
Mailing Address - Fax:850-973-8365
Practice Address - Street 1:486 SW RUTLEDGE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-1978
Practice Address - Country:US
Practice Address - Phone:850-973-8851
Practice Address - Fax:850-973-8365
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252709000Medicaid
38053OtherBCBS
593122517OtherCOMMERCIAL
38053OtherBCBS
G65692Medicare UPIN