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: 09/19/2025
Certification Date: 09/19/2025
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 TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number02008625A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS8957
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: