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General NPI Number Information
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NPI Number | 1093171019
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Entity Type | Organization
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Legal Business Name | LEON P PERLSTEIN, D.P.M., P.A.
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 5961 NW 61ST AVE APT 101
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City | TAMARAC
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State | FL
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Zip | 33319-2217
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Country | US
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Telephone | 754-666-3338
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Fax | 754-200-6057
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Provider Business Mailing Address
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Address Line | 2520 MARINA BAY DR E APT 104
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-2322
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Country | US
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Telephone | 786-315-1111
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Fax | 754-200-6057
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Authorized Official
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Title or Position | DOCTOR/PRESIDENT
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Name | LEON PERRY PERLSTEIN
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Credential | DPM
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Telephone | 754-666-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO3054
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License Number State | FL
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