Healthcare Provider Details

I. General information

NPI: 1053369553
Provider Name (Legal Business Name): DONNA S PERKINS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

762 N SCENIC HWY
BABSON PARK FL
33827-9795
US

IV. Provider business mailing address

105 TOMOKA BLVD S
LAKE PLACID FL
33852-8123
US

V. Phone/Fax

Practice location:
  • Phone: 863-638-3400
  • Fax: 863-638-3625
Mailing address:
  • Phone: 863-465-7010
  • Fax: 863-465-7266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1524622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: