Provider Demographics
NPI:1386890002
Name:PAUL E PERITO MD PA
Entity type:Organization
Organization Name:PAUL E PERITO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:PERITO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-444-2920
Mailing Address - Street 1:2601 SW 37TH AVE
Mailing Address - Street 2:SUITE 905
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2700
Mailing Address - Country:US
Mailing Address - Phone:305-444-2920
Mailing Address - Fax:305-446-9377
Practice Address - Street 1:2601 SW 37TH AVE
Practice Address - Street 2:SUITE 905
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2700
Practice Address - Country:US
Practice Address - Phone:305-444-2920
Practice Address - Fax:305-446-9377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0060097174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty