Healthcare Provider Details

I. General information

NPI: 1689159238
Provider Name (Legal Business Name): RONY PERRIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2018
Last Update Date: 09/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 W BLUE HERON BLVD
RIVIERA BEACH FL
33418-7813
US

IV. Provider business mailing address

PO BOX 849122
HOLLYWOOD FL
33084-1122
US

V. Phone/Fax

Practice location:
  • Phone: 561-840-0754
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT13605
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: