Healthcare Provider Details

I. General information

NPI: 1174562326
Provider Name (Legal Business Name): ROBERT PERKINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1722 DEL PRADO BLVD S
CAPE CORAL FL
33990-5525
US

IV. Provider business mailing address

750 N COMMONS DR STE 200
AURORA IL
60504-7940
US

V. Phone/Fax

Practice location:
  • Phone: 239-458-7900
  • Fax: 239-458-9977
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2092
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAS4993
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: