Provider Demographics
NPI:1285691980
Name:ALFRED, PERIN (MD)
Entity type:Individual
Prefix:DR
First Name:PERIN
Middle Name:
Last Name:ALFRED
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:PO BOX 3008
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-3008
Mailing Address - Country:US
Mailing Address - Phone:352-629-1199
Mailing Address - Fax:
Practice Address - Street 1:6041 SW 73RD ST RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-5608
Practice Address - Country:US
Practice Address - Phone:352-629-1199
Practice Address - Fax:352-629-1341
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 64129207RP1001X, 207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377265900Medicaid
FLE36726Medicare UPIN
FL26228XMedicare PIN