Provider Demographics
NPI:1215980438
Name:PERL, MIKE (MD)
Entity type:Individual
Prefix:DR
First Name:MIKE
Middle Name:
Last Name:PERL
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 1:5901 COLONIAL DR STE 301
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5683
Mailing Address - Country:US
Mailing Address - Phone:954-935-1477
Mailing Address - Fax:954-935-1422
Practice Address - Street 1:5901 COLONIAL DR STE 301
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5683
Practice Address - Country:US
Practice Address - Phone:954-935-1477
Practice Address - Fax:954-935-1422
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48608207R00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02743Medicare ID - Type Unspecified