Healthcare Provider Details

I. General information

NPI: 1831374685
Provider Name (Legal Business Name): PAMELA MARIE PERRIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 CURLEW ROAD SUITE 106
OLDSMAR FL
34677-2629
US

IV. Provider business mailing address

3180 CURLEW ROAD SUITE 106
OLDSMAR FL
34677-2629
US

V. Phone/Fax

Practice location:
  • Phone: 850-778-1547
  • Fax: 727-286-7738
Mailing address:
  • Phone: 850-778-1547
  • Fax: 727-286-7738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1375092
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1375092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: