Provider Demographics
NPI:1972546612
Name:HALPERIN, SCOTT B (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:B
Last Name:HALPERIN
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 1:5355 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2100
Mailing Address - Country:US
Mailing Address - Phone:305-821-5261
Mailing Address - Fax:305-646-1606
Practice Address - Street 1:5355 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2100
Practice Address - Country:US
Practice Address - Phone:305-821-5261
Practice Address - Fax:305-646-1606
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047579207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056063400Medicaid
FLD50870Medicare UPIN
FL03896Medicare ID - Type UnspecifiedMEDICARE PROVIDER #