=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124003546
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANTHONY TREVOR PERRIN DO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2005
-----------------------------------------------------
Last Update Date | 09/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1236 ROYAL PALM BLVD SUITE 108
-----------------------------------------------------
City | ROYAL PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-774-8660
-----------------------------------------------------
Fax | 561-774-8665
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 952816
-----------------------------------------------------
City | LAKE MARY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32795-2816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-716-5776
-----------------------------------------------------
Fax | 321-256-0667
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VX0000X
-----------------------------------------------------
Taxonomy Name | Obstetrics Physician
-----------------------------------------------------
License Number | 02008625A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | OS8957
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------