Healthcare Provider Details

I. General information

NPI: 1063591329
Provider Name (Legal Business Name): RANDI GAIL PERLMAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JACKSON MEMORIAL HOSPITAL 1611 NW 12 AVE
MIAMI FL
33136
US

IV. Provider business mailing address

4300 CASPER CT
HOLLYWOOD FL
33021-2414
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-5116
  • Fax:
Mailing address:
  • Phone: 954-966-0961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0955132
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: