Healthcare Provider Details

I. General information

NPI: 1124003546
Provider Name (Legal Business Name): ANTHONY TREVOR PERRIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 ROYAL PALM BLVD SUITE 108
ROYAL PALM BEACH FL
33411
US

IV. Provider business mailing address

PO BOX 952816
LAKE MARY FL
32795-2816
US

V. Phone/Fax

Practice location:
  • Phone: 561-774-8660
  • Fax: 561-774-8665
Mailing address:
  • Phone: 407-716-5776
  • Fax: 321-256-0667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS8957
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC2-0024999
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOP70058153
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOP70058153
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDO4371
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: