Healthcare Provider Details

I. General information

NPI: 1235224221
Provider Name (Legal Business Name): VARISA BORIBOON PERLMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 ARTHUR GODFREY RD SUITE 408
MIAMI BEACH FL
33140-3329
US

IV. Provider business mailing address

975 ARTHUR GODFREY RD SUITE 408
MIAMI BEACH FL
33140-3329
US

V. Phone/Fax

Practice location:
  • Phone: 305-672-7337
  • Fax: 305-672-6555
Mailing address:
  • Phone: 305-672-7337
  • Fax: 305-672-6665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME110041
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: