MEDICARE: WILLIAM STANLEY PERRY HEALTH SERVICES TECH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

General Provider Information

NPI Number	:	1659462562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM STANLEY PERRY HEALTH SERVICES TECH

Provider Business Mailing Address
First Line	:	4134 FOREST DR
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33332-2136
Country	:	US
Telephone Number	:	305-953-2266
Fax Number	:	305-953-2308

Provider Business Practice Location Address
First Line	:	14750 NW 44TH CT
Second Line	:
City	:	OPA LOCKA
State	:	FL
Zip	:	33054-2304
Country	:	US
Telephone Number	:	305-953-2266
Fax Number	:	305-953-2308

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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